ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 2459

Use of Nailfold Capillaroscopy as a Predictor of Cardiovascular Events and Mortality in Systemic Sclerosis

Carlos Valera-Ribera1, Javier Narvaez-García2, Joaquín Lacasa-Molina3, Laura Perea-Galera4, Alida Taberner-Cortés3, Paula Andrea Mencio-Viana3, Patricia Leon-Torralba3, Adrián Mayo-Juanatey3, Pablo Andújar-Brazal3, Ignacio Vázquez Gómez5, Desamparados Ybáñez-García3, Àngels Martínez-Ferrer6, Elia Valls-Pascual7, Montserrat Robustillo Villarino8 and JUAN JOSE ALEGRE SANCHO3, 1Hospital Doctor Peset, Valéncia, Comunidad Valenciana, Spain, 2Hospital Universitario de Bellvitge, Barcelona, Spain, 3Hospital Universitario Doctor Peset, Valencia, Spain, 4Hospital Universitario Doctor Peset, Valencia, 5H. U. Dr. Peset, Valencia, 6Hospital Universitario Dr Peset Valéncia, Valéncia, Spain, 7Hospital General de Valencia, Valencia, Comunidad Valenciana, Spain, 8Hospital Universitario La Plana, Villarreal, Spain

Meeting: ACR Convergence 2024

Keywords: Cardiovascular, Imaging, Scleroderma, Systemic, Systemic sclerosis

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Monday, November 18, 2024

Title: Systemic Sclerosis & Related Disorders – Clinical Poster III

Session Type: Poster Session C

Session Time: 10:30AM-12:30PM

Background/Purpose: Systemic sclerosis (SSc) is a disease with high morbidity and mortality. Nailfold capillaroscopy (NFC) is a widely used method for its diagnosis. Our objective was to analyze the association between NFC at the time of diagnosis and major adverse cardiovascular events (MACEs) and mortality, during follow-up. 

Methods: Multicenter retrospective observational study which included all patients from a longitudinal SSc cohort, classified according to the EULAR/ACR 2013 criteria, followed between 1984 and 2023. The demographic, clinical and laboratory data were recorded.

The qualitative analysis of the findings in the NFC at the time of the diagnosis included the presence of megacapillaries, hemorrhages and avascular areas, as well as Cutolo’s SSc NFC patterns. MACEs and deaths, as well as their respective causes, were obtained from the patient’s medical history.

An univariate analysis was carried out and a multivariate logistic regression model was built, examining the effect of the findings in the NFC on the clinical events. To study the survival of patients, Kaplan-Meier curves and Cox-regression models, were designed. The statistical analysis was performed using SPSS v.26.

Results: 360 patients were included. The baseline characteristics are described in table 1.

In the NFC at baseline, 88% presented with scleroderma patterns of microvascular damage (29.7% early, 29.2% active and 22.5% late). 69.7% exhibited megacapillaries, 48.6% hemorrhages and 38.6% avascular areas.

In the univariate model, there was a positive association between age (p = 0.000), arterial hypertension [AH] (p = 0.001), dyslipidemia (p = 0.0022), diabetes mellitus (p = 0.0035), interstitial lung disease [ILD] (p = 0.001), pulmonary hypertension [PH] (p = 0.000), digital ulcers [DUs] (p = 0.000), renal involvement (p = 0.009), cardiac involvement [CI] (p = 0.000), calcinosis (p = 0.009), previous MACE (p = 0.000), and avascular areas (p = 0.000) with MACEs. Hemorrhages had a negative association (p = 0.013).

There was a positive association between age (p = 0.000, p = 0.001), disease duration (p = 0.000, p = 0.005), AH (p = 0.000, p = 0.016), ILD (p = 0.000, p = 0.000), CI (p = 0.000, p = 0.000), DUs (p = 0.002, p = 0.045), previous MACE (0.002, p = 0.027) and avascular areas (p = 0.000) with all-cause mortality and mortality by SSc, respectively. Moreover, both outcomes had a negative association with hemorrhages (p = 0.023, p = 0.018).

For mortality by MACE, age (p = 0.000), AH (p = 0.006), PH (p = 0.000), DUs (p = 0.006), CI (p = 0.000), previous MACE (p = 0.027) and avascular areas (p = 0.000) were associated.

The results of the logistic regression models, for MACEs, all-cause mortality, mortality due to SSc and mortality due to MACE, are presented in table 2.

The Kaplan-Meier curve showing the effect of avascular areas on survival rates is presented in figure 1 (log rank p-value = 0.000). The Hazard ratio (HR) for hemorrhages and all-cause mortality was 0.421 (p = 0.006) and 0.315 (p = 0.043) for death by SSc.

Conclusion: Presence of avascular areas in NFC at baseline are an independent risk factor for all-cause mortality and specifically due to SSc. Hemorrhages seem to have a protective effect on SSc survival rate, acting as a sign of the early stages of the microvascular damage.

Supporting image 1

Table 1: Demographic, clinical and immunological characteristics of the participants.

Supporting image 2

Table 2: Logistic regression models for MACEs, all-cause mortality, mortality attributable to SSc and mortality by MACEs.

Supporting image 3

Figure 1: Kaplan-Meier curve for patients with avascular areas and mortality by SSc.


Disclosures: C. Valera-Ribera: None; J. Narvaez-García: None; J. Lacasa-Molina: None; L. Perea-Galera: None; A. Taberner-Cortés: None; P. Mencio-Viana: None; P. Leon-Torralba: None; A. Mayo-Juanatey: None; P. Andújar-Brazal: None; I. Vázquez Gómez: None; D. Ybáñez-García: None; À. Martínez-Ferrer: None; E. Valls-Pascual: None; M. Robustillo Villarino: None; J. ALEGRE SANCHO: None.

To cite this abstract in AMA style:

Valera-Ribera C, Narvaez-García J, Lacasa-Molina J, Perea-Galera L, Taberner-Cortés A, Mencio-Viana P, Leon-Torralba P, Mayo-Juanatey A, Andújar-Brazal P, Vázquez Gómez I, Ybáñez-García D, Martínez-Ferrer À, Valls-Pascual E, Robustillo Villarino M, ALEGRE SANCHO J. Use of Nailfold Capillaroscopy as a Predictor of Cardiovascular Events and Mortality in Systemic Sclerosis [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/use-of-nailfold-capillaroscopy-as-a-predictor-of-cardiovascular-events-and-mortality-in-systemic-sclerosis/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to ACR Convergence 2024

ACR Meeting Abstracts - https://acrabstracts.org/abstract/use-of-nailfold-capillaroscopy-as-a-predictor-of-cardiovascular-events-and-mortality-in-systemic-sclerosis/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology