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• W4313554815 abstract "In a large population-based observational study, Nathalie Conrad and colleagues1Conrad N Verbeke G Molenberghs G et al.Autoimmune diseases and cardiovascular risk: a population-based study on 19 autoimmune diseases and 12 cardiovascular diseases in 22 million individuals in the UK.Lancet. 2022; 400: 733-743Summary Full Text Full Text PDF PubMed Scopus (59) Google Scholar showed the association between 19 autoimmune diseases and 12 cardiovascular diseases (CVDs) with data from about 22 000 000 people in the UK. However, we are concerned about the possibly confusing message caused by treating several CVDs as a composite outcome in this study. Although the association between autoimmune diseases and specific CVDs, such as atherosclerotic diseases, valve disorders, arrhythmias, and others were analysed separately, the main findings were based on a composite outcome combining all these diseases. Because the pathophysiology of each disease is different, the confounding factors for each should be different. For example, blood pressure, smoking status, cholesterol, and BMI might be confounding factors for atherosclerotic diseases, whereas they might not be for valve disorders, myocarditis, or pericarditis. Besides, the risk and type of associated CVDs vary largely for each autoimmune disease.2Mason JC Libby P Cardiovascular disease in patients with chronic inflammation: mechanisms underlying premature cardiovascular events in rheumatologic conditions.Eur Heart J. 2015; 36 (49c): 482Crossref PubMed Scopus (275) Google Scholar For example, steroids, non-steroidal anti-inflammatory drugs, and biological drugs are used only for particular autoimmune diseases, and their dose and duration could affect the association between those diseases ans some CVDs. Steroids can treat inflammation-related CVDs such as myocarditis3Tschöpe C Cooper LT Torre-Amione G Van Linthout S Management of Myocarditis-related cardiomyopathy in adults.Circ Res. 2019; 124: 1568-1583Crossref PubMed Scopus (152) Google Scholar but can also be a risk factor for atherosclerotic diseases.4Wei L MacDonald TM Walker BR Taking glucocorticoids by prescription is associated with subsequent cardiovascular disease.Ann Intern Med. 2004; 141: 764-770Crossref PubMed Scopus (590) Google Scholar Additionally, people with systemic lupus erythematosus are at risk of various CVDs but, depending on the mechanisms, the prevention and treatment strategy could be totally different.5Fanouriakis A Kostopoulou M Alunno A et al.2019 update of the EULAR recommendations for the management of systemic lupus erythematosus.Ann Rheum Dis. 2019; 78: 736-745Crossref PubMed Scopus (1012) Google Scholar Therefore, to clarify the risk of CVDs in autoimmune diseases and send practical messages to clinical practice, examining the association between the 19 autoimmune diseases and 12 CVDs separately would be preferable, accounting for relevant confounding factors for each situation. SF received a grant from the Japan Society for the Promotion of Science (JSPS) KAKENHI (grant number JP 20K18964) and the Kyoto University School of Public Health Crossover Award in 2022. YL received a grant from JSPS KAKENHI (grant number 22K21112). TY received a grant from JSPS KAKENHI (grant number JP 21K17228). NN declares no competing interests. Autoimmune diseases and cardiovascular risk: a population-based study on 19 autoimmune diseases and 12 cardiovascular diseases in 22 million individuals in the UKThese findings warrant targeted cardiovascular prevention measures, in particular in younger patients with autoimmune diseases, and further research into pathophysiological mechanisms underlying these complications. Full-Text PDF" @default.
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• W4313554815 date "2023-01-01" @default.
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• W4313554815 title "Cardiovascular risk in systemic autoimmune diseases" @default.
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• W4313554815 doi "https://doi.org/10.1016/s0140-6736(22)02474-6" @default.
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