Despite a high incidence rate of acute myocardial infarction (MI), prevalence of cardiovascular (CV) risk factors was found to be low among patients with idiopathic inflammatory myopathies (IIMs).
Compared with the general population, individuals with systemic autoimmune diseases are at higher CV risk; however, the associated metabolic pathways are unclear.
A systematic review aimed to assess CV risk factors in IIMs and included 20 articles published between 2009 and 2022.
Among the pooled study population of 18,974 patients, 75.3% had dermatomyositis, 9.0% had polymyositis, and 0.26% had antisynthetase syndrome. The majority of patients (96.5%) were women with a mean age between 50 and 79 years; between 40% and 60% of patients used glucocorticoids and other immunosuppressive therapies.
The rates of acute MI and stroke were 13.2% and 0.9%, respectively. The rates of common CV comorbidities and risk factors were low, with 9.2% having comorbid hypertension, 4.4% diabetes mellitus, and 3.0% alcoholism and 4.8% being smokers. Overall, patients had an average abdominal circumference of 90 cm or greater and body mass index (BMI) of 26.1.
According to laboratory analyses, the mean fasting blood glucose level was 89.5 mg/dL, low-density lipoprotein cholesterol level was 152 mg/dL, high-density lipoprotein cholesterol was 88.5 mg/dL, and triglyceride level was 117 mg/dL in the IIM population.
The limitations of the review were that most studies did not have a control group; small sample sizes; retrospective nature; and paucity of data on the duration of CV risk factors.
The review authors concluded, “[I]t seems that the prevalence of the cardiovascular risk factors was generally low in IIMs, but with a high incidence of acute myocardial infarction. Thus, prospective studies are needed to compare populations stratified by continent (for example, Western [vs] Eastern population, male [vs] female) and risk factors to better understand the impact of each risk factor on the cardiovascular health of patients with IIMs.”
Júnior JC, Shinjo SK. Assessment of cardiovascular risk factors in patients with idiopathic inflammatory myopathies: a systematic review. Clin Rheumatol. Published online May 16, 2023. doi:10.1007/s10067-023-06633-5