Concomitant Ro/SSA and La/SSB antibodies are biomarkers for the risk of venous thromboembolism and cerebral infarction in primary Sjögren's syndrome
Identifieur interne : 000873 ( Pmc/Checkpoint ); précédent : 000872; suivant : 000874Concomitant Ro/SSA and La/SSB antibodies are biomarkers for the risk of venous thromboembolism and cerebral infarction in primary Sjögren's syndrome
Auteurs : J. Mofors ; M. Holmqvist ; L. Westermark ; A. Björk ; M. Kvarnström ; H. Forsblad-D'Elia ; S. Magnusson Bucher ; P. Eriksson ; E. Theander ; T. Mandl ; M. Wahren-Herlenius ; G. NordmarkSource :
- Journal of Internal Medicine [ 0954-6820 ] ; 2019.
Abstract
To assess the risk of incident cardiovascular disease in patients with primary Sjögren's syndrome, overall and stratified by Ro/
A cohort of patients with primary Sjögren's syndrome in Sweden (
During a median follow‐up of 9.5 years, the overall hazard ratio (
Primary Sjögren's syndrome is associated with a markedly increased risk of cardiovascular disease and the presence of Ro/
Url:
DOI: 10.1111/joim.12941
PubMed: 31127862
PubMed Central: 6851863
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Concomitant Ro/<styled-content style="fixed-case" toggle="no">SSA</styled-content> and La/<styled-content style="fixed-case" toggle="no">SSB</styled-content> antibodies are biomarkers for the risk of venous thromboembolism and cerebral infarction in primary Sjögren's syndrome</title><author><name sortKey="Mofors, J" sort="Mofors, J" uniqKey="Mofors J" first="J." last="Mofors">J. Mofors</name><affiliation><nlm:aff id="joim12941-aff-0001"></nlm:aff></affiliation></author><author><name sortKey="Holmqvist, M" sort="Holmqvist, M" uniqKey="Holmqvist M" first="M." last="Holmqvist">M. Holmqvist</name><affiliation><nlm:aff id="joim12941-aff-0002"></nlm:aff></affiliation></author><author><name sortKey="Westermark, L" sort="Westermark, L" uniqKey="Westermark L" first="L." last="Westermark">L. Westermark</name><affiliation><nlm:aff id="joim12941-aff-0003"></nlm:aff></affiliation></author><author><name sortKey="Bjork, A" sort="Bjork, A" uniqKey="Bjork A" first="A." last="Björk">A. Björk</name><affiliation><nlm:aff id="joim12941-aff-0001"></nlm:aff></affiliation></author><author><name sortKey="Kvarnstrom, M" sort="Kvarnstrom, M" uniqKey="Kvarnstrom M" first="M." last="Kvarnström">M. Kvarnström</name><affiliation><nlm:aff id="joim12941-aff-0001"></nlm:aff></affiliation></author><author><name sortKey="Forsblad Elia, H" sort="Forsblad Elia, H" uniqKey="Forsblad Elia H" first="H." last="Forsblad-D'Elia">H. Forsblad-D'Elia</name><affiliation><nlm:aff id="joim12941-aff-0004"></nlm:aff></affiliation></author><author><name sortKey="Magnusson Bucher, S" sort="Magnusson Bucher, S" uniqKey="Magnusson Bucher S" first="S." last="Magnusson Bucher">S. Magnusson Bucher</name><affiliation><nlm:aff id="joim12941-aff-0005"></nlm:aff></affiliation></author><author><name sortKey="Eriksson, P" sort="Eriksson, P" uniqKey="Eriksson P" first="P." last="Eriksson">P. Eriksson</name><affiliation><nlm:aff id="joim12941-aff-0006"></nlm:aff></affiliation></author><author><name sortKey="Theander, E" sort="Theander, E" uniqKey="Theander E" first="E." last="Theander">E. Theander</name><affiliation><nlm:aff id="joim12941-aff-0007"></nlm:aff></affiliation></author><author><name sortKey="Mandl, T" sort="Mandl, T" uniqKey="Mandl T" first="T." last="Mandl">T. Mandl</name><affiliation><nlm:aff id="joim12941-aff-0007"></nlm:aff></affiliation></author><author><name sortKey="Wahren Erlenius, M" sort="Wahren Erlenius, M" uniqKey="Wahren Erlenius M" first="M." last="Wahren-Herlenius">M. Wahren-Herlenius</name><affiliation><nlm:aff id="joim12941-aff-0001"></nlm:aff></affiliation></author><author><name sortKey="Nordmark, G" sort="Nordmark, G" uniqKey="Nordmark G" first="G." last="Nordmark">G. Nordmark</name><affiliation><nlm:aff id="joim12941-aff-0003"></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">31127862</idno><idno type="pmc">6851863</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6851863</idno><idno type="RBID">PMC:6851863</idno><idno type="doi">10.1111/joim.12941</idno><date when="2019">2019</date><idno type="wicri:Area/Pmc/Corpus">000680</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000680</idno><idno type="wicri:Area/Pmc/Curation">000680</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000680</idno><idno type="wicri:Area/Pmc/Checkpoint">000873</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000873</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Concomitant Ro/<styled-content style="fixed-case" toggle="no">SSA</styled-content> and La/<styled-content style="fixed-case" toggle="no">SSB</styled-content> antibodies are biomarkers for the risk of venous thromboembolism and cerebral infarction in primary Sjögren's syndrome</title><author><name sortKey="Mofors, J" sort="Mofors, J" uniqKey="Mofors J" first="J." last="Mofors">J. Mofors</name><affiliation><nlm:aff id="joim12941-aff-0001"></nlm:aff></affiliation></author><author><name sortKey="Holmqvist, M" sort="Holmqvist, M" uniqKey="Holmqvist M" first="M." last="Holmqvist">M. Holmqvist</name><affiliation><nlm:aff id="joim12941-aff-0002"></nlm:aff></affiliation></author><author><name sortKey="Westermark, L" sort="Westermark, L" uniqKey="Westermark L" first="L." last="Westermark">L. Westermark</name><affiliation><nlm:aff id="joim12941-aff-0003"></nlm:aff></affiliation></author><author><name sortKey="Bjork, A" sort="Bjork, A" uniqKey="Bjork A" first="A." last="Björk">A. Björk</name><affiliation><nlm:aff id="joim12941-aff-0001"></nlm:aff></affiliation></author><author><name sortKey="Kvarnstrom, M" sort="Kvarnstrom, M" uniqKey="Kvarnstrom M" first="M." last="Kvarnström">M. Kvarnström</name><affiliation><nlm:aff id="joim12941-aff-0001"></nlm:aff></affiliation></author><author><name sortKey="Forsblad Elia, H" sort="Forsblad Elia, H" uniqKey="Forsblad Elia H" first="H." last="Forsblad-D'Elia">H. Forsblad-D'Elia</name><affiliation><nlm:aff id="joim12941-aff-0004"></nlm:aff></affiliation></author><author><name sortKey="Magnusson Bucher, S" sort="Magnusson Bucher, S" uniqKey="Magnusson Bucher S" first="S." last="Magnusson Bucher">S. Magnusson Bucher</name><affiliation><nlm:aff id="joim12941-aff-0005"></nlm:aff></affiliation></author><author><name sortKey="Eriksson, P" sort="Eriksson, P" uniqKey="Eriksson P" first="P." last="Eriksson">P. Eriksson</name><affiliation><nlm:aff id="joim12941-aff-0006"></nlm:aff></affiliation></author><author><name sortKey="Theander, E" sort="Theander, E" uniqKey="Theander E" first="E." last="Theander">E. Theander</name><affiliation><nlm:aff id="joim12941-aff-0007"></nlm:aff></affiliation></author><author><name sortKey="Mandl, T" sort="Mandl, T" uniqKey="Mandl T" first="T." last="Mandl">T. Mandl</name><affiliation><nlm:aff id="joim12941-aff-0007"></nlm:aff></affiliation></author><author><name sortKey="Wahren Erlenius, M" sort="Wahren Erlenius, M" uniqKey="Wahren Erlenius M" first="M." last="Wahren-Herlenius">M. Wahren-Herlenius</name><affiliation><nlm:aff id="joim12941-aff-0001"></nlm:aff></affiliation></author><author><name sortKey="Nordmark, G" sort="Nordmark, G" uniqKey="Nordmark G" first="G." last="Nordmark">G. Nordmark</name><affiliation><nlm:aff id="joim12941-aff-0003"></nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Internal Medicine</title><idno type="ISSN">0954-6820</idno><idno type="eISSN">1365-2796</idno><imprint><date when="2019">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Abstract</title><sec id="joim12941-sec-0001"><title>Background</title><p>To assess the risk of incident cardiovascular disease in patients with primary Sjögren's syndrome, overall and stratified by Ro/<styled-content style="fixed-case" toggle="no">SSA</styled-content> and La/<styled-content style="fixed-case" toggle="no">SSB</styled-content> autoantibody status.</p></sec><sec id="joim12941-sec-0002"><title>Methods</title><p>A cohort of patients with primary Sjögren's syndrome in Sweden (<italic>n</italic> = 960) and matched controls from the general population (<italic>n</italic> = 9035) were included, and data extracted from the National Patient Register to identify events of myocardial infarction, cerebral infarction and venous thromboembolism. Hazard ratios were estimated using cox proportional hazard regressions.</p></sec><sec id="joim12941-sec-0003"><title>Results</title><p>During a median follow‐up of 9.5 years, the overall hazard ratio (<styled-content style="fixed-case" toggle="no">HR</styled-content>) was 1.6 (95% <styled-content style="fixed-case" toggle="no">CI</styled-content> 1.2–2.1) for myocardial infarction, 1.2 (95% <styled-content style="fixed-case" toggle="no">CI</styled-content> 0.9–1.7) for cerebral infarction and 2.1 (95% <styled-content style="fixed-case" toggle="no">CI</styled-content> 1.6–2.9) for venous thromboembolism. Patients positive for both Ro/<styled-content style="fixed-case" toggle="no">SSA</styled-content> and La/<styled-content style="fixed-case" toggle="no">SSB</styled-content> autoantibodies had a substantially higher risk of cerebral infarction (<styled-content style="fixed-case" toggle="no">HR</styled-content> 1.7, 95% <styled-content style="fixed-case" toggle="no">CI</styled-content> 1.0–2.9) and venous thromboembolism (<styled-content style="fixed-case" toggle="no">HR</styled-content> 3.1, 95% <styled-content style="fixed-case" toggle="no">CI</styled-content> 1.9–4.8) than the general population. These risks were not significantly increased in Ro/<styled-content style="fixed-case" toggle="no">SSA</styled-content>‐ and La/<styled-content style="fixed-case" toggle="no">SSB</styled-content>‐negative patients. Among autoantibody‐positive patients, the highest <styled-content style="fixed-case" toggle="no">HR</styled-content> of cerebral infarction was seen after ≥10 years disease duration (<styled-content style="fixed-case" toggle="no">HR</styled-content> 2.8, 95% <styled-content style="fixed-case" toggle="no">CI</styled-content> 1.4–5.4), while the <styled-content style="fixed-case" toggle="no">HR</styled-content> for venous thromboembolism was highest 0–5 years after disease diagnosis (<styled-content style="fixed-case" toggle="no">HR</styled-content> 4.7, 95% <styled-content style="fixed-case" toggle="no">CI</styled-content> 2.3–9.3) and remained high throughout disease duration.</p></sec><sec id="joim12941-sec-0004"><title>Conclusions</title><p>Primary Sjögren's syndrome is associated with a markedly increased risk of cardiovascular disease and the presence of Ro/<styled-content style="fixed-case" toggle="no">SSA</styled-content> and La/<styled-content style="fixed-case" toggle="no">SSB</styled-content> autoantibodies identify the subgroup of patients carrying the highest risk. These findings suggest that monitoring and prevention of cardiovascular disease in this patient group should be considered.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Intern Med</journal-id><journal-id journal-id-type="iso-abbrev">J. Intern. Med</journal-id><journal-id journal-id-type="doi">10.1111/(ISSN)1365-2796</journal-id><journal-id journal-id-type="publisher-id">JOIM</journal-id><journal-title-group><journal-title>Journal of Internal Medicine</journal-title></journal-title-group><issn pub-type="ppub">0954-6820</issn><issn pub-type="epub">1365-2796</issn><publisher><publisher-name>John Wiley and Sons Inc.</publisher-name><publisher-loc>Hoboken</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">31127862</article-id><article-id pub-id-type="pmc">6851863</article-id><article-id pub-id-type="doi">10.1111/joim.12941</article-id><article-id pub-id-type="publisher-id">JOIM12941</article-id><article-categories><subj-group subj-group-type="overline"><subject>Original Article</subject></subj-group><subj-group subj-group-type="heading"><subject>Original Articles</subject></subj-group></article-categories><title-group><article-title>Concomitant Ro/<styled-content style="fixed-case" toggle="no">SSA</styled-content> and La/<styled-content style="fixed-case" toggle="no">SSB</styled-content> antibodies are biomarkers for the risk of venous thromboembolism and cerebral infarction in primary Sjögren's syndrome</article-title><alt-title alt-title-type="right-running-head">Cardiovascular disease in pSS</alt-title><alt-title alt-title-type="left-running-head">J. Mofors <italic>et al</italic>.</alt-title></title-group><contrib-group><contrib id="joim12941-cr-0001" contrib-type="author"><name><surname>Mofors</surname><given-names>J.</given-names></name><xref ref-type="aff" rid="joim12941-aff-0001"><sup>1</sup></xref></contrib><contrib id="joim12941-cr-0002" contrib-type="author"><name><surname>Holmqvist</surname><given-names>M.</given-names></name><xref ref-type="aff" rid="joim12941-aff-0002"><sup>2</sup></xref></contrib><contrib id="joim12941-cr-0003" contrib-type="author"><name><surname>Westermark</surname><given-names>L.</given-names></name><xref ref-type="aff" rid="joim12941-aff-0003"><sup>3</sup></xref></contrib><contrib id="joim12941-cr-0004" contrib-type="author"><name><surname>Björk</surname><given-names>A.</given-names></name><xref ref-type="aff" rid="joim12941-aff-0001"><sup>1</sup></xref></contrib><contrib id="joim12941-cr-0005" contrib-type="author"><name><surname>Kvarnström</surname><given-names>M.</given-names></name><xref ref-type="aff" rid="joim12941-aff-0001"><sup>1</sup></xref></contrib><contrib id="joim12941-cr-0006" contrib-type="author"><name><surname>Forsblad‐d'Elia</surname><given-names>H.</given-names></name><xref ref-type="aff" rid="joim12941-aff-0004"><sup>4</sup></xref></contrib><contrib id="joim12941-cr-0007" contrib-type="author"><name><surname>Magnusson Bucher</surname><given-names>S.</given-names></name><xref ref-type="aff" rid="joim12941-aff-0005"><sup>5</sup></xref></contrib><contrib id="joim12941-cr-0008" contrib-type="author"><name><surname>Eriksson</surname><given-names>P.</given-names></name><xref ref-type="aff" rid="joim12941-aff-0006"><sup>6</sup></xref></contrib><contrib id="joim12941-cr-0009" contrib-type="author"><name><surname>Theander</surname><given-names>E.</given-names></name><xref ref-type="aff" rid="joim12941-aff-0007"><sup>7</sup></xref></contrib><contrib id="joim12941-cr-0010" contrib-type="author"><name><surname>Mandl</surname><given-names>T.</given-names></name><xref ref-type="aff" rid="joim12941-aff-0007"><sup>7</sup></xref></contrib><contrib id="joim12941-cr-0011" contrib-type="author"><name><surname>Wahren‐Herlenius</surname><given-names>M.</given-names></name><contrib-id contrib-id-type="orcid" authenticated="false">https://orcid.org/0000-0002-0915-7245</contrib-id><xref ref-type="aff" rid="joim12941-aff-0001"><sup>1</sup></xref></contrib><contrib id="joim12941-cr-0012" contrib-type="author" corresp="yes"><name><surname>Nordmark</surname><given-names>G.</given-names></name><contrib-id contrib-id-type="orcid" authenticated="false">https://orcid.org/0000-0002-3829-7431</contrib-id><xref ref-type="aff" rid="joim12941-aff-0003"><sup>3</sup></xref><address><email>gunnel.nordmark@medsci.uu.se</email></address></contrib></contrib-group><aff id="joim12941-aff-0001"><label><sup>1</sup></label><named-content content-type="organisation-division">Division of Rheumatology</named-content><named-content content-type="organisation-division">Department of Medicine</named-content><institution>Karolinska Institutet</institution><institution>Karolinska University Hospital</institution><city>Stockholm</city><country country="SE">Sweden</country></aff><aff id="joim12941-aff-0002"><label><sup>2</sup></label><named-content content-type="organisation-division">Division of Clinical Epidemiology</named-content><named-content content-type="organisation-division">Department of Medicine</named-content><institution>Karolinska Institutet</institution><city>Stockholm</city><country country="SE">Sweden</country></aff><aff id="joim12941-aff-0003"><label><sup>3</sup></label><named-content content-type="organisation-division">Department of Medical Sciences</named-content><named-content content-type="organisation-division">Rheumatology and Science for Life Laboratory</named-content><institution>Uppsala University</institution><city>Uppsala</city><country country="SE">Sweden</country></aff><aff id="joim12941-aff-0004"><label><sup>4</sup></label><named-content content-type="organisation-division">Department of Public Health and Clinical Medicine, Rheumatology</named-content><institution>Umeå University</institution><city>Umeå</city><country country="SE">Sweden</country></aff><aff id="joim12941-aff-0005"><label><sup>5</sup></label><named-content content-type="organisation-division">Department of Rheumatology</named-content><named-content content-type="organisation-division">Faculty of Medicine and Health</named-content><institution>Örebro University</institution><city>Örebro</city><country country="SE">Sweden</country></aff><aff id="joim12941-aff-0006"><label><sup>6</sup></label><named-content content-type="organisation-division">Division of Rheumatology</named-content><named-content content-type="organisation-division">Department of Clinical Experimental Medicine</named-content><institution>Linköping University</institution><city>Linköping</city><country country="SE">Sweden</country></aff><aff id="joim12941-aff-0007"><label><sup>7</sup></label><named-content content-type="organisation-division">Department of Clinical Sciences, Malmö, Rheumatology</named-content><institution>Lund University</institution><city>Malmö</city><country country="SE">Sweden</country></aff><author-notes><corresp id="correspondenceTo"><label>*</label><italic>Correspondence:</italic> Gunnel Nordmark, Department of Medical Sciences, Rheumatology and Science for Life Laboratory, Uppsala University, S‐751 85 Uppsala, Sweden.<break></break>(fax: +46-18-55 84 32; e‐mail: <email>gunnel.nordmark@medsci.uu.se</email>).<break></break></corresp></author-notes><pub-date pub-type="epub"><day>17</day><month>6</month><year>2019</year></pub-date><pub-date pub-type="ppub"><month>10</month><year>2019</year></pub-date><volume>286</volume><issue>4</issue><issue-id pub-id-type="doi">10.1111/joim.v286.4</issue-id><fpage>458</fpage><lpage>468</lpage><permissions><pmc-comment> Copyright © 2019 The Association for the Publication of the Journal of Internal Medicine </pmc-comment>
<copyright-statement content-type="article-copyright">© 2019 The Authors. <italic>Journal of Internal Medicine</italic> published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine.</copyright-statement><license license-type="creativeCommonsBy"><license-p>This is an open access article under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link> License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><self-uri content-type="pdf" xlink:href="file:JOIM-286-458.pdf"></self-uri><abstract id="joim12941-abs-0001"><title>Abstract</title><sec id="joim12941-sec-0001"><title>Background</title><p>To assess the risk of incident cardiovascular disease in patients with primary Sjögren's syndrome, overall and stratified by Ro/<styled-content style="fixed-case" toggle="no">SSA</styled-content> and La/<styled-content style="fixed-case" toggle="no">SSB</styled-content> autoantibody status.</p></sec><sec id="joim12941-sec-0002"><title>Methods</title><p>A cohort of patients with primary Sjögren's syndrome in Sweden (<italic>n</italic> = 960) and matched controls from the general population (<italic>n</italic> = 9035) were included, and data extracted from the National Patient Register to identify events of myocardial infarction, cerebral infarction and venous thromboembolism. Hazard ratios were estimated using cox proportional hazard regressions.</p></sec><sec id="joim12941-sec-0003"><title>Results</title><p>During a median follow‐up of 9.5 years, the overall hazard ratio (<styled-content style="fixed-case" toggle="no">HR</styled-content>) was 1.6 (95% <styled-content style="fixed-case" toggle="no">CI</styled-content> 1.2–2.1) for myocardial infarction, 1.2 (95% <styled-content style="fixed-case" toggle="no">CI</styled-content> 0.9–1.7) for cerebral infarction and 2.1 (95% <styled-content style="fixed-case" toggle="no">CI</styled-content> 1.6–2.9) for venous thromboembolism. Patients positive for both Ro/<styled-content style="fixed-case" toggle="no">SSA</styled-content> and La/<styled-content style="fixed-case" toggle="no">SSB</styled-content> autoantibodies had a substantially higher risk of cerebral infarction (<styled-content style="fixed-case" toggle="no">HR</styled-content> 1.7, 95% <styled-content style="fixed-case" toggle="no">CI</styled-content> 1.0–2.9) and venous thromboembolism (<styled-content style="fixed-case" toggle="no">HR</styled-content> 3.1, 95% <styled-content style="fixed-case" toggle="no">CI</styled-content> 1.9–4.8) than the general population. These risks were not significantly increased in Ro/<styled-content style="fixed-case" toggle="no">SSA</styled-content>‐ and La/<styled-content style="fixed-case" toggle="no">SSB</styled-content>‐negative patients. Among autoantibody‐positive patients, the highest <styled-content style="fixed-case" toggle="no">HR</styled-content> of cerebral infarction was seen after ≥10 years disease duration (<styled-content style="fixed-case" toggle="no">HR</styled-content> 2.8, 95% <styled-content style="fixed-case" toggle="no">CI</styled-content> 1.4–5.4), while the <styled-content style="fixed-case" toggle="no">HR</styled-content> for venous thromboembolism was highest 0–5 years after disease diagnosis (<styled-content style="fixed-case" toggle="no">HR</styled-content> 4.7, 95% <styled-content style="fixed-case" toggle="no">CI</styled-content> 2.3–9.3) and remained high throughout disease duration.</p></sec><sec id="joim12941-sec-0004"><title>Conclusions</title><p>Primary Sjögren's syndrome is associated with a markedly increased risk of cardiovascular disease and the presence of Ro/<styled-content style="fixed-case" toggle="no">SSA</styled-content> and La/<styled-content style="fixed-case" toggle="no">SSB</styled-content> autoantibodies identify the subgroup of patients carrying the highest risk. These findings suggest that monitoring and prevention of cardiovascular disease in this patient group should be considered.</p></sec></abstract><abstract abstract-type="graphical" id="joim12941-abs-0002"><p><boxed-text position="anchor" content-type="graphic" id="joim12941-blkfxd-0001" orientation="portrait"><graphic xlink:href="JOIM-286-458-g004.jpg" position="anchor" id="nlm-graphic-1" orientation="portrait"></graphic></boxed-text></p></abstract><kwd-group kwd-group-type="author-generated"><kwd id="joim12941-kwd-0001">autoantibodies</kwd><kwd id="joim12941-kwd-0002">cardiovascular disease</kwd><kwd id="joim12941-kwd-0003">La/<styled-content style="fixed-case" toggle="no">SSB</styled-content></kwd><kwd id="joim12941-kwd-0004">Primary Sjögren's syndrome</kwd><kwd id="joim12941-kwd-0005">Ro/<styled-content style="fixed-case" toggle="no">SSA</styled-content></kwd></kwd-group><funding-group><award-group id="funding-0001"><funding-source><institution-wrap><institution>Swedish Research Council </institution><institution-id institution-id-type="open-funder-registry">10.13039/501100004359</institution-id></institution-wrap></funding-source></award-group><award-group id="funding-0002"><funding-source>Swedish Rheumatism Association</funding-source></award-group><award-group id="funding-0003"><funding-source>King Gustaf the V:th 80‐year Foundation</funding-source></award-group><award-group id="funding-0004"><funding-source>Heart‐Lung Foundation</funding-source></award-group><award-group id="funding-0005"><funding-source>Stockholm County Council</funding-source></award-group><award-group id="funding-0006"><funding-source><institution-wrap><institution>Karolinska Institute </institution><institution-id institution-id-type="open-funder-registry">10.13039/501100004047</institution-id></institution-wrap></funding-source></award-group></funding-group><counts><fig-count count="3"></fig-count><table-count count="2"></table-count><page-count count="11"></page-count><word-count count="6615"></word-count></counts><custom-meta-group><custom-meta><meta-name>source-schema-version-number</meta-name><meta-value>2.0</meta-value></custom-meta><custom-meta><meta-name>cover-date</meta-name><meta-value>October 2019</meta-value></custom-meta><custom-meta><meta-name>details-of-publishers-convertor</meta-name><meta-value>Converter:WILEY_ML3GV2_TO_JATSPMC version:5.7.1 mode:remove_FC converted:13.11.2019</meta-value></custom-meta></custom-meta-group></article-meta><notes><p content-type="self-citation"><mixed-citation publication-type="journal" id="joim12941-cit-1001"><string-name><surname>Mofors</surname><given-names>J</given-names></string-name>, <string-name><surname>Holmqvist</surname><given-names>M</given-names></string-name>, <string-name><surname>Westermark</surname><given-names>L</given-names></string-name>, <string-name><surname>Björk</surname><given-names>A</given-names></string-name>, <string-name><surname>Kvarnström</surname><given-names>M</given-names></string-name>, <string-name><surname>Forsblad‐d'Elia</surname><given-names>H</given-names></string-name>, <string-name><surname>Magnusson Bucher</surname><given-names>S</given-names></string-name>, <string-name><surname>Eriksson</surname><given-names>P</given-names></string-name>, <string-name><surname>Theander</surname><given-names>E</given-names></string-name>, <string-name><surname>Mandl</surname><given-names>T</given-names></string-name>, <string-name><surname>Wahren‐Herlenius</surname><given-names>M</given-names></string-name>, <string-name><surname>Nordmark</surname><given-names>G</given-names></string-name> (Karolinska Institutet, Karolinska University Hospital; Karolinska Institutet, Stockholm; Uppsala University, Uppsala; Umeå University, Umeå; Örebro University, Örebro; Linköping University, Linköping; Lund University, Malmö, Sweden). <article-title>Concomitant Ro/SSA and La/SSB antibodies are biomarkers for the risk of venous thromboembolism and cerebral infarction in primary Sjögren's syndrome</article-title>. <source xml:lang="en">J Intern Med</source><year>2019</year>;<volume>286</volume>:<fpage>458</fpage>–<lpage>468</lpage>.<pub-id pub-id-type="pmid">31127862</pub-id></mixed-citation></p></notes></front></pmc><affiliations><list></list><tree><noCountry><name sortKey="Bjork, A" sort="Bjork, A" uniqKey="Bjork A" first="A." last="Björk">A. Björk</name><name sortKey="Eriksson, P" sort="Eriksson, P" uniqKey="Eriksson P" first="P." last="Eriksson">P. Eriksson</name><name sortKey="Forsblad Elia, H" sort="Forsblad Elia, H" uniqKey="Forsblad Elia H" first="H." last="Forsblad-D'Elia">H. Forsblad-D'Elia</name><name sortKey="Holmqvist, M" sort="Holmqvist, M" uniqKey="Holmqvist M" first="M." last="Holmqvist">M. Holmqvist</name><name sortKey="Kvarnstrom, M" sort="Kvarnstrom, M" uniqKey="Kvarnstrom M" first="M." last="Kvarnström">M. Kvarnström</name><name sortKey="Magnusson Bucher, S" sort="Magnusson Bucher, S" uniqKey="Magnusson Bucher S" first="S." last="Magnusson Bucher">S. Magnusson Bucher</name><name sortKey="Mandl, T" sort="Mandl, T" uniqKey="Mandl T" first="T." last="Mandl">T. Mandl</name><name sortKey="Mofors, J" sort="Mofors, J" uniqKey="Mofors J" first="J." last="Mofors">J. Mofors</name><name sortKey="Nordmark, G" sort="Nordmark, G" uniqKey="Nordmark G" first="G." last="Nordmark">G. Nordmark</name><name sortKey="Theander, E" sort="Theander, E" uniqKey="Theander E" first="E." last="Theander">E. Theander</name><name sortKey="Wahren Erlenius, M" sort="Wahren Erlenius, M" uniqKey="Wahren Erlenius M" first="M." last="Wahren-Herlenius">M. Wahren-Herlenius</name><name sortKey="Westermark, L" sort="Westermark, L" uniqKey="Westermark L" first="L." last="Westermark">L. Westermark</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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