Estratificação de risco cardiovascular global nos portadores de esclerose sistêmica: um estudo transversal

Abstract

Introduction: Systemic sclerosis (SSc) is a complex autoimmune pathology that belongs to a heterogeneous group of diseases whose main characteristic is skin fibrosis, affecting everything from the integumentary tissue alone to internal organs. Like other autoimmune diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), an accelerated atherosclerosis process occurs in systemic sclerosis that is not completely explained by traditional cardiovascular risk factors such as obesity, smoking and hyperlipidemia. Typical cardiovascular diseases (CVD) are not the most common cardiovascular complications in SSc, however studies show that their prevalence is increased in comparison to the general population and accounts for around 8-15% of SSc-related deaths. In this context, cardiovascular risk scores are tools that estimate the risk of developing cardiovascular diseases. Among traditional risk algorithms, the Framingham Global Risk Score (GRS) is one of the most used and validated. Thus, considering the increased prevalence of CVD in SSc, the current study sought to stratify cardiovascular risk based on the GRS of patients diagnosed with SSc followed up at a reference outpatient service in the State of Paraíba. Methodology: This was an observational, cross-sectional study, carried out in the Pulmonology and Rheumatology outpatient clinics of the Lauro Wanderley University Hospital between September 2022 and August 2023, and between July 2024 and September 2024. Patients aged between 30 and 74 years of age and diagnosed with SSc according to the 2013 ACR/EULAR criteria were included in the study. Results: 20 patients were included in the sample. 100% (n=20) of patients were female. Of these, 20% (n=4) were white, 70% (n=14) were brown and 10% (n=2) were black, 95% (n=19) of the patients had the limited SSc subtype and only 5 % (n=1) had the diffuse subtype. The mean ± SD duration of the disease was 10.32 ± 5.01 years. The cardiovascular risk calculated by ERG had a median of 4.8%. Regarding distribution by risk classification, 50% (n=10) were classified as low cardiovascular risk, 35% (n=7) as intermediate risk and 15% (n=3) as high risk. Conclusions: A distribution of risk categories similar to those found in the literature was observed, with a predominance of low and medium risk respectively and a prevalence of women, middle-aged and mixed-race people with a high prevalence of overweight and a limited subtype of SSc, with a considerable percentage of hypertensive patients.