Background/Purpose: Systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are associated with an increased risk of ischemic heart disease (IHD). The risk of IHD in patients with Sjögren’s syndrome (SS) from previous observational studies has been inconclusive. Therefore, we conducted a meta-analysis to compare incidence of IHD in SS patients to normal populations.

Methods: Two investigators (J.T. and S.S.) searched published articles in EMBASE and PubMed database from 1980 to the end of May 2017 using the terms “Sjögren’s syndrome” and terms of ischemic heart disease. The diagnosis of Sjögren’s syndrome was made by physicians (primary care, rheumatologist) or retrieved from medical records using ICD-9-CM code 710.2. A manual search in the conferences abstract database from 2002-2017 was performed. Inclusion criteria were 1) observational studies (cohort, case control, cross sectional studies), 2) studies comparing incidence of IHD in SS and normal populations. Exclusion criteria were pediatric patients and non English-language articles. Quality assessment of studies was performed using Newcastle-Ottawa quality assessment scale. Review Manager 5.3 software was used to perform data analysis. We used a random-effect model because of the variance in the studies. Cochran’s Q test was used to calculate I² to measure heterogeneity across studies. A funnel plot was used to assess for publication bias.

Results: We identified 243 studies from the search. Five studies met our criteria (3 cohort studies, one case-controlled study and one cross-sectional study) with total 21,261 SJS patients. The pooled risk ratio for IHD in SJS patients compared to control populations was 1.27 (95% CI 0.91-1.79).

Conclusion: This meta-analysis did not find statistically significant increased risk of IHD in SJS patients compared to the general population.