Pulmonary arterial hypertension, peripheral arterial disease predict VTE in systemic sclerosis
The risk of venous thromboembolism (VTE) in systemic sclerosis (SSc) is similar to that in the general population, according to a recent study. Risk factors for VTE include the presence of pulmonary arterial hypertension (PAH), peripheral arterial disease (PAD), Scl-70 and anticardiolipin antibodies.
In addition, VTE is not an independent predictor of SSc survival.
A total of 1,181 patients with SSs were included, of which 40 (3.4 percent) had VTE events. There was a 2.7 (95 percent CI, 1.9–3.7) cumulative incidence of VTE per 1,000 patient-years.
VTE was predicted by the following: PAH (odds ratio [OR], 3.77; 1.83–8.17), PAD (OR, 5.31; 1.99–12.92), Scl-70 (OR, 2.45; 1.07–5.30) and anticardiolipin antibodies (OR, 5.70; 1.16–21.17). A total of 440 deaths occurred.
Furthermore, no difference in survival was observed between patients with and without VTE (hazard ratio [HR], 1.16; 0.70–1.91). Interstitial lung disease (HR, 1.54; 1.27–1.88) and PAH (HR, 1.35; 1.10–1.65) predicted mortality.
To examine the prevalence, risk factors and effect of VTE on SSc survival, the investigators conducted a cohort study of patients with SSc who fulfilled the American College of Rheumatology/European League Against Rheumatism classification criteria between 1970 and 2017.
Deep vein thrombosis referred to the thrombus on extremity ultrasound, while pulmonary embolism referred to the thrombus on thorax computed tomography angiogram. Finally, the investigators assessed the risk factors for VTE as well as time to all-cause mortality.