Calcinosis is associated with digital ischaemia in systemic sclerosis-a longitudinal study
| Autor: | Geneviève Gyger, Nader Khalidi, Marie Hudson, Murray Baron, Douglas Smith, Janet E. Pope, Paul R. Fortin, Tatiana S. Rodriguez-Reyna, Niall Jones, Evelyn Sutton, Jean-Pierre Mathieu, Sharon LeClercq, Marvin J. Fritzler, Maggie Larché, Mianbo Wang, Ariel Masetto, Elzbieta Kaminska, Tamara Grodzicky, Peter Docherty, Sophie Ligier, David Robinson, Carter Thorne, Maysan Abu-Hakima, Antonio R. Cabral-Castaneda |
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| Rok vydání: | 2015 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty Time Factors genetic structures medicine.medical_treatment Systemic scleroderma Gastroenterology Scleroderma Fingers 03 medical and health sciences 0302 clinical medicine Rheumatology Calcinosis Ischemia Internal medicine medicine Humans Pharmacology (medical) cardiovascular diseases Longitudinal Studies Registries skin and connective tissue diseases 030203 arthritis & rheumatology Gangrene Scleroderma Systemic integumentary system business.industry Proportional hazards model Hazard ratio Odds ratio Middle Aged Clinical Science medicine.disease Calcium Channel Blockers 030104 developmental biology Cross-Sectional Studies Amputation Female business |
| Zdroj: | Rheumatology (Oxford, England). 55(12) |
| ISSN: | 1462-0332 |
| Popis: | Objective To determine if ischaemia is a causal factor in the development of calcinosis in SSc. Methods Patients with SSc were assessed yearly. Physicians reported the presence of calcinosis, digital ischaemia (digital ulcers, digital necrosis/gangrene, loss of digital pulp on any digits and/or auto- or surgical digital amputation) and nailfold capillary dropout assessed using a dermatoscope. The number of digits with digital ischaemia was used as an assessment of the severity of digital ischaemia. SSc specific antibodies were detected with a line immunoassay. Multiple logistic regression and Cox proportional hazards models were generated to determine associations between calcinosis, digital ischaemia and capillary dropout. Results One thousand three hundred and five patients were included in this study, of whom 300 (23.0%) had calcinosis at study entry. In a cross-sectional multivariate analysis, at baseline, calcinosis was associated with digital ischaemia (odds ratio (OR) = 2.37, 95% CI: 1.66, 3.39), severity of ischaemia (OR = 1.12, 95% CI: 1.06, 1.18), capillary dropout (OR = 1.41, 95% CI: 1.05, 1.89), ACAs (OR = 1.68, 95% CI: 1.17, 2.43) and anti-RNA polymerase III antibodies (OR = 1.77, 95% CI: 1.08, 2.89). Current use of calcium channel blockers was inversely associated with the presence of calcinosis (OR = 0.70, 95% CI: 0.52, 0.96). Of the 805 patients with no calcinosis at study entry and at least one follow-up visit, 215 (26.7%) developed calcinosis during follow-up. Significant baseline predictors of the development of calcinosis in follow-up were digital ischaemia (hazard ratio (HR) = 1.82, 95% CI: 1.30, 2.54), capillary dropout (HR = 1.46, 95% CI: 1.08, 1.99), dcSSc (HR = 1.57, 95% CI: 1.11, 2.21), ACA (HR = 2.18, 95% CI: 1.50, 3.17) and anti-RNA polymerase III antibodies (HR = 2.58, 95% CI: 1.65, 4.04). Conclusion Ischaemia may play a role in the development of calcinosis in SSc. |
| Databáze: | OpenAIRE |
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