A gender gap in primary and secondary heart dysfunctions in systemic sclerosis: a EUSTAR prospective study. Issue 1 (23rd October 2014)

• Record Type: Journal Article
• Authors: Elhai, Muriel; Avouac, Jérôme; Walker, Ulrich A; Matucci-Cerinic, Marco; Riemekasten, Gabriela; Airò, Paolo; Hachulla, Eric; Valentini, Gabriele; Carreira, Patricia E; Cozzi, Franco; Balbir Gurman, Alexandra; Braun-Moscovici, Yolanda; Damjanov, Nemanja; Ananieva, Lidia P; Scorza, Raffaella; Jimenez, Sergio; Busquets, Joanna; Li, Mengtao; Müller-Ladner, Ulf; Kahan, André; Distler, Oliver; Allanore, Yannick
• Other Names: author non-byline.; Guiducci Serena author non-byline.; Tyndall Alan author non-byline.; Lapadula Giovanni author non-byline.; Iannone Florenzo author non-byline.; Becvar Radim author non-byline.; Sierakowsky Stanislaw author non-byline.; Bielecka Otylia Kowal author non-byline.; Cutolo Maurizio author non-byline.; Sulli Alberto author non-byline.; Cuomo Giovanna author non-byline.; Vettori Serena author non-byline.; Rednic Simona author non-byline.; Nicoara Ileana author non-byline.; Vlachoyiannopoulos P. author non-byline.; Montecucco C. author non-byline.; Caporali Roberto author non-byline.; Novak Srdan author non-byline.; Czirják László author non-byline.; Varju Cecilia author non-byline.; Chizzolini Carlo author non-byline.; Kucharz Eugene J. author non-byline.; Kotulska Anna author non-byline.; Kopec-Medrek Magdalena author non-byline.; Widuchowska Malgorzata author non-byline.; Rozman Blaz author non-byline.; Mallia Carmel author non-byline.; Coleiro Bernard author non-byline.; Gabrielli Armando author non-byline.; Farge Dominique author non-byline.; Hij Adrian author non-byline.; Hesselstrand Roger author non-byline.; Scheja Agneta author non-byline.; Wollheim Frank author non-byline.; Martinovic Duska author non-byline.; Govoni M. author non-byline.; Monaco Andrea Lo author non-byline.; Hunzelmann Nicolas author non-byline.; Pellerito Raffaele author non-byline.; Bambara Lisa Maria author non-byline.; Caramaschi Paola author non-byline.; Black Carol author non-byline.; Denton Christopher author non-byline.; Henes Jörg author non-byline.; Santamaria Vera Ortiz author non-byline.; Heitmann Stefan author non-byline.; Krasowska Dorota author non-byline.; Seidel Matthias author non-byline.; Oleszowsky Mara author non-byline.; Burkhardt Harald author non-byline.; Himsel Andrea author non-byline.; Salvador Maria J. author non-byline.; Stamenkovic Bojana author non-byline.; Stankovic Aleksandra author non-byline.; Tikly Mohammed author non-byline.; Starovoytova Maya N. author non-byline.; Engelhart Merete author non-byline.; Strauss Gitte author non-byline.; Nielsen Henrik author non-byline.; Damgaard Kirsten author non-byline.; Szücs Gabriella author non-byline.; Zea Mendoza Antonio author non-byline.; de la Puente Buijdos Carlos author non-byline.; Sifuentes Giraldo Walter A. author non-byline.; Midtvedt Øyvind author non-byline.; Garen Torhild author non-byline.; Launay David author non-byline.; Valesini Guido author non-byline.; Riccieri Valeria author non-byline.; Ionescu Ruxandra Maria author non-byline.; Opris Daniela author non-byline.; Groseanu Laura author non-byline.; Wigley Fredrick M. author non-byline.; Mihai Carmen M. author non-byline.; Cornateanu Roxana Sfrent author non-byline.; Ionitescu Razvan author non-byline.; Gherghe Ana Maria author non-byline.; Gorga Marilena author non-byline.; Dobrota Rucsandra author non-byline.; Bojinca Mihai author non-byline.; Schett Georg author non-byline.; Distler Jörg HW author non-byline.; Meroni Pierluigi author non-byline.; Zeni Silvana author non-byline.; Mouthon Luc author non-byline.; Keyser Filip De author non-byline.; Smith Vanessa author non-byline.; Cantatore Francesco P. author non-byline.; Corrado Ada author non-byline.; Ullman Susanne author non-byline.; Iversen Line author non-byline.; Pozzi Maria R. author non-byline.; Eyerich Kilian author non-byline.; Hein Rüdiger author non-byline.; Knott Elisabeth author non-byline.; Szechinski Jacek author non-byline.; Wiland Piotr author non-byline.; Szmyrka-Kaczmarek Magdalena author non-byline.; Sokolik Renata author non-byline.; Morgiel Ewa author non-byline.; Krummel-Lorenz Brigitte author non-byline.; Saar Petra author non-byline.; Aringer Martin author non-byline.; Günther Claudia author non-byline.; Anic Branimir author non-byline.; Baresic Marko author non-byline.; Mayer Miroslav author non-byline.; Radominski Sebastião C. author non-byline.; Müller Carolina de Souza author non-byline.; Azevedo Valderílio F. author non-byline.; Agachi Svetlana author non-byline.; Groppa Liliana author non-byline.; Chiaburu Lealea author non-byline.; Russu Eugen author non-byline.; Zenone Thierry author non-byline.; Stebbings Simon author non-byline.; Highton John author non-byline.; Stamp Lisa author non-byline.; Chapman Peter author non-byline.; Baron Murray author non-byline.; O'Donnell John author non-byline.; Solanki Kamal author non-byline.; Doube Alan author non-byline.; Veale Douglas author non-byline.; O'Rourke Marie author non-byline.; Loyo Esthela author non-byline.; Rosato Edoardo author non-byline.; Pisarri Simonetta author non-byline.; Tanaseanu Cristina-Mihaela author non-byline.; Popescu Monica author non-byline.; Dumitrascu Alina author non-byline.; Tiglea Isabela author non-byline.; Chirieac Rodica author non-byline.; Ancuta Codrina author non-byline.; Furst Daniel E. author non-byline.; Kafaja Suzanne author non-byline.; Lefebvre Paloma García de la Peña author non-byline.; Rubio Silvia Rodriguez author non-byline.; Exposito Marta Valero author non-byline.; Sibilia Jean author non-byline.; Chatelus Emmanuel author non-byline.; Gottenberg Jacques Eric author non-byline.; Chifflot Hélène author non-byline.; Litinsky Ira author non-byline.; Venalis Algirdas author non-byline.; Butrimiene Irena author non-byline.; Venalis Paulius author non-byline.; Rugiene Rita author non-byline.; Karpec Diana author non-byline.; Kerzberg Eduardo author non-byline.; Montoya Fabiana author non-byline.; Cosentino Vanesa author non-byline.;
• Is Part Of: Annals of the rheumatic diseases. Volume 75:Issue 1(2016)
• Page Start: 163
• Page End: 169
• Publication Date: 2014-10-23
• Subjects: Autoimmune Diseases -- Epidemiology -- Systemic Sclerosis; Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2014-206386
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Objectives: In agreement with other autoimmune diseases, systemic sclerosis (SSc) is associated with a strong sex bias. However, unlike lupus, the effects of sex on disease phenotype and prognosis are poorly known. Therefore, we aimed to determine sex effects on outcomes. Method: We performed a prospective observational study using the latest 2013 data extract from the EULAR scleroderma trials and research (EUSTAR) cohort. We looked at (i) sex influence on disease characteristics at baseline and (ii) then focused on patients with at least 2 years of follow-up to estimate the effects of sex on disease progression and survival. Results: 9182 patients with SSc were available (1321 men) for the baseline analyses. In multivariate analysis, male sex was independently associated with a higher risk of diffuse cutaneous subtype (OR: 1.68, (1.45 to 1.94); p<0.001), a higher frequency of digital ulcers (OR: 1.28 (1.11 to 1.47); p<0.001) and pulmonary hypertension (OR: 3.01 (1.47 to 6.20); p<0.003). In the longitudinal analysis (n=4499), after a mean follow-up of 4.9 (±2.7) years, male sex was predictive of new onset of pulmonary hypertension (HR: 2.66 (1.32 to 5.36); p=0.006) and heart failure (HR: 2.22 (1.06 to 4.63); p=0.035). 908 deaths were recorded, male sex predicted deaths of all origins (HR: 1.48 (1.19 to 1.84); p<0.001), but did not significantly account for SSc-related deaths. Conclusions: Although more common in women, SSc appears as strikingly more severe in men. Our results obtained through the largest worldwide database demonstrate a higher risk of severe cardiovascular involvement in men. These results raise the point of including sex in the management and the decision-making process.