Seminars in arthritis and rheumatism · 2025
Nailfold capillaroscopy as a predictor of major cardiovascular events and mortality in systemic sclerosis.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Valera-Ribera Carlos, Alegre-Sancho Juan José, Lacasa-Molina Joaquín, Robustillo-Villarino Montserrat, Narváez Javier
Аннотация
OBJECTIVE: To assess the predictive value of nailfold capillaroscopy (NFC) findings for major cardiovascular events (MCEs) and mortality in systemic sclerosis (SSc) patients, in comparison with other clinical variables.
METHODS: This retrospective, observational study included 360 SSc patients diagnosed according to the 2013 ACR/EULAR criteria. All patients underwent NFC within one month of diagnosis.
RESULTS: At baseline, 88% of patients presented a scleroderma NFC pattern (33.05% early, 32.5% active, and 22.5% late). Giant capillaries were found in 75.28%, microhaemorrhages in 54.17%, and avascular areas in 38.6% of patients. During a median follow-up of 11.7 years, 64 patients (17.8%) experienced a MCE. The overall mortality rate was 21.1% (76 patients), with 30.9% of deaths attributed to SSc-related complications, 29.4% to MCEs, and 39.7% to other causes. In multivariable analyses, independent predictors of MCEs were diabetes mellitus (HR 2.37, p = 0.031), interstitial lung disease (HR 3.16, p < 0.001), avascular areas on baseline NFC (HR 2.24, p = 0.034), and previous MCE (HR 3.89, p < 0.001). Whereas, microhaemorrhages showed protective trend (HR 0.55, p = 0.053). Independent predictors of all-cause mortality were age (HR 1.03, p = 0.039), disease duration (HR 0.81, p < 0.001), and avascular areas (HR 2.09, p = 0.032), while microhaemorrhages were protective (HR 0.35, p = 0.002) For SSc-related mortality rates, avascular areas associated with a poorer survival rate (log-rank p-value <0.001) and microhaemorrhages with a better survival (log rank p-value = 0.01).
CONCLUSION: Avascular areas in baseline NFC are strong predictors of MCEs and mortality in SSc, whereas microhaemorrhages have a lower risk. Integrating NFC into clinical practice as a prognostic tool may improve risk stratification.
METHODS: This retrospective, observational study included 360 SSc patients diagnosed according to the 2013 ACR/EULAR criteria. All patients underwent NFC within one month of diagnosis.
RESULTS: At baseline, 88% of patients presented a scleroderma NFC pattern (33.05% early, 32.5% active, and 22.5% late). Giant capillaries were found in 75.28%, microhaemorrhages in 54.17%, and avascular areas in 38.6% of patients. During a median follow-up of 11.7 years, 64 patients (17.8%) experienced a MCE. The overall mortality rate was 21.1% (76 patients), with 30.9% of deaths attributed to SSc-related complications, 29.4% to MCEs, and 39.7% to other causes. In multivariable analyses, independent predictors of MCEs were diabetes mellitus (HR 2.37, p = 0.031), interstitial lung disease (HR 3.16, p < 0.001), avascular areas on baseline NFC (HR 2.24, p = 0.034), and previous MCE (HR 3.89, p < 0.001). Whereas, microhaemorrhages showed protective trend (HR 0.55, p = 0.053). Independent predictors of all-cause mortality were age (HR 1.03, p = 0.039), disease duration (HR 0.81, p < 0.001), and avascular areas (HR 2.09, p = 0.032), while microhaemorrhages were protective (HR 0.35, p = 0.002) For SSc-related mortality rates, avascular areas associated with a poorer survival rate (log-rank p-value <0.001) and microhaemorrhages with a better survival (log rank p-value = 0.01).
CONCLUSION: Avascular areas in baseline NFC are strong predictors of MCEs and mortality in SSc, whereas microhaemorrhages have a lower risk. Integrating NFC into clinical practice as a prognostic tool may improve risk stratification.