AB1297 CARDIOVASCULAR EVENT AND RISK FACTORS IN PRIMARY SJÖGREN’S SYNDROME FROM LATIN-AMERICAN COHORT
Authors: Valeria Valim, Gabriela Hernandez-Molina, Virginia Fernandes Moça Trevisani, Maria Lúcia Lemos Lopes, Aysa Cesar Pinheiro, Anastasia Secco, Sabrina Zanardi Machado, Samira Tatiyama Miyamoto, Patricia Sasaki, Antonio Catalán-Pellet
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Inflammation has been associated with higher cardiovascular risk in rheumatic autoimmune diseases. Primary Sjögren's syndrome (pSS) is associated with increased cardiovascular morbidity<sup>1</sup>. However, few and controversy data on the prevalence of cardiovascular events in patients with pSS have been reported<sup>2,3</sup> with no data regarding on Latin-American pSS patients. <h3>Objectives</h3> To assess the cardiovascular event and to evaluate its association with traditional and disease associated risk factors in pSS. <h3>Methods</h3> We included 455 patients with pSS according to AECG 2002 or ACR-EULAR 2016 classification criteria, attending tertiary referral centers from Brazil (n=183), Mexico (n=236) and Argentina (n=36). We retrospectively registered demographics, disease duration, cardiovascular event (CE) (coronary heart disease, cerebrovascular accident, peripheral arterial disease), smoking, and use of prednisone (PDN), immunosupressors and antimalarials. We evaluated traditional risk factors and scored the ESSDAI, ESSPRI and SSDDI at last follow-up. <h3>Results</h3> Most patients were female, miscigenous ethnicity, with median disease duration of 9.5 years. RF was positive in 48.5%, ANA in 85.6%, anti-Ro-SSA in 78.9% and anti-La-SSA in 43.1%. ESSDAI mean was 3.2±4.4, SSDDI 2.54±1.78 and ESSPRI 5.03±2.38. Fifty five percent used glucocorticoid in the past and 20% are curruntly using it, 33.4% are using immunosupressors, 44% antimalarials and 10.3% biological therapy. It was found 26 (5.7%, CI95% 3.73-8.37) CE. The prevalence of hypertension was 35.6%, diabetes 11.2%, dyslipidemia 27.7% and smoking 17.5%. In univariate regression analysis, aging, hypertension, diabetes, dyslipidemia and smoking were associated with CE. Beyond traditional risk factors, prednisone &gt; 20mg/day, ESSDAI constitutional domain and ESSPRI fatigue were associated with CE. In multivariate analysis, aging OR= 1.037 (1.001-1.075, p= 0.043), hypertension OR=2.509 (1.028-6.128, p=0.043) and diabetes OR= 2.736 (1.059-7.070, 0.038) were independent risk for CE. <h3>Conclusion</h3> Traditional risk factors are independent risk for CE in pSS. Disease-associated factors, such as glucocorticoid, fatigue and disease activity seem to be associated and should be explored in larger samples. <h3>References</h3> [1] Beltai A, et al. Cardiovascular morbidity and mortality in primary Sjögren syndrome: a systematic review and meta-analysis. Arthritis Care Res, 2018 (Epub ahead of print); [2] Valim V, et al. Atherosclerosis in Sjögren's syndrome: evidence, possible mechanisms and knowledge gaps. Gerdts Clin Exp Rheumatol.34(1):133-42, 2016. [3] Berardicurti O, et al. Cardiovascular Disease in Primary Sjögren's Syndrome. Rev Recent Clin Trial 13(3):164-169, 2018. <h3>Disclosure of Interests</h3> None declared