Background/Purpose: It is well documented that patients with immune-mediated inflammatory diseases (IMID) like rheumatoid arthritis are exposed at an increased risk of cardiovascular disease. Primary Sjögren syndrome (PJS) is a progressive autoimmune disease characterized by a chronic inflammation of exocrine glands and a functional deficit of the salivary and lachrymal glands, biological inflammation being infrequent. The purpose of this article was to investigate the association between PJS and an increase of the cardiovascular morbidity and mortality.

Methods: We performed a systematic review of available articles on the databases of MEDLINE and the COCHRANE library from their dates of inception to January 2017 and recent abstracts from ACR and EULAR meetings, searching for studies reporting observed cardiovascular morbidity and cardiovascular mortality in PJS and having a comparison group. The relative risks of cardiovascular morbidity and mortality associated with PJS were collected and pooled in meta-analysis using Review Manager Software (Cochrane collaboration). Random effects meta-analyses were conducted, and forest plots were constructed to summarize the risk ratio estimates and their 95% confidence intervals. The heterogeneity between studies was assessed using the Cochran’s Q-test and the I2 value.

Results: 457 studies were retrieved, among which 26 involving 61254 PJS patients met the inclusion criteria and were analyzed after the selection procedure was applied. Ten studies involving 32 907 PJS patients were included in the meta-analysis. The studies showed that patients with PJS had a significantly increased prevalence of coronary morbidity (relative risk (RR)= 1.75, 95%CI : 1.36-2.25; p<0.0001), cerebrovascular morbidity (RR= 1.46, 95%CI : 1.43-1.49, p<0.00001), heart failure rate (odd ratio (OR)=2.54, 95%CI: 1.30 – 4.97, p<0.007), thromboembolic morbidity ( RR= 1.78, 95% confidence interval (CI) :1.41- 2.25, p<0.00001), and a trend to increased cardiovascular mortality ((RR)= 1.48, 95%CI : 0.77-2.85, p=0.24) compared to the control population without IMID.

Conclusion: This meta-analysis demonstrates that PJS is associated with an increased cardiovascular morbidity suggesting that these patients should also been proposed for a screening of cardiovascular comorbidities and specific preventive interventions.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/cardiovascular-morbidity-and-mortality-in-primary-sjogren-syndrome-a-systematic-review-and-meta-analysis/