BACKGROUND: There is a paucity of literature on the patterns and predictors of mortality in idiopathic inflammatory myopathies (IIM). AIMS: To determine the patterns and predictors of mortality in a South Australian cohort of patients with biopsy-proven IIM. METHODS: The living/deceased status (and for deceased patients the causes of death) of patients with histologically determined IIM was determined from the Births, Deaths and Marriages Registry. Standardised mortality ratios (SMR) were generated compared with the age/gender matched South Australian population. The effect of presence/absence of the components of the Bohan and Peter criteria on risk ratios (RR) for mortality was determined. The effect of comorbidities and autoantibodies on mortality was investigated. RESULTS: The SMR for mortality in IIM was 1.75 and was significantly increased in all disease subgroups, being highest in patients with dermatomyositis (2.40). Dominant causes of death were cardiovascular disease (31%), infections (22%) and malignancy (11%). Risk factors for death were age at time of biopsy (hazard ratio 1.05), ischaemic heart disease (RR 2.97, P < 0.0001), proximal weakness at diagnosis (RR 1.8, P= 0.03), definite diagnosis of IIM per the Bohan and Peter criteria (RR 2.14, P < 0.0001), and the absence of autoantibodies (RR 1.9, P < 0.001). CONCLUSIONS: Patients with IIM are at 75% increased risk for mortality, and cardiovascular diseases account for the commonest causes of death. This study suggests a thorough cardiovascular evaluation of these patients is indicated, and raises the possibility that targeted interventions such as the use of aspirin or statins may improve outcomes in IIM.
BACKGROUND: There is a paucity of literature on the patterns and predictors of mortality in idiopathic inflammatory myopathies (IIM). AIMS: To determine the patterns and predictors of mortality in a South Australian cohort of patients with biopsy-proven IIM. METHODS: The living/deceased status (and for deceased patients the causes of death) of patients with histologically determined IIM was determined from the Births, Deaths and Marriages Registry. Standardised mortality ratios (SMR) were generated compared with the age/gender matched South Australian population. The effect of presence/absence of the components of the Bohan and Peter criteria on risk ratios (RR) for mortality was determined. The effect of comorbidities and autoantibodies on mortality was investigated. RESULTS: The SMR for mortality in IIM was 1.75 and was significantly increased in all disease subgroups, being highest in patients with dermatomyositis (2.40). Dominant causes of death were cardiovascular disease (31%), infections (22%) and malignancy (11%). Risk factors for death were age at time of biopsy (hazard ratio 1.05), ischaemic heart disease (RR 2.97, P < 0.0001), proximal weakness at diagnosis (RR 1.8, P= 0.03), definite diagnosis of IIM per the Bohan and Peter criteria (RR 2.14, P < 0.0001), and the absence of autoantibodies (RR 1.9, P < 0.001). CONCLUSIONS:Patients with IIM are at 75% increased risk for mortality, and cardiovascular diseases account for the commonest causes of death. This study suggests a thorough cardiovascular evaluation of these patients is indicated, and raises the possibility that targeted interventions such as the use of aspirin or statins may improve outcomes in IIM.
Authors: Sara G Murray; Gabriela Schmajuk; Laura Trupin; Erica Lawson; Matthew Cascino; Jennifer Barton; Mary Margaretten; Patricia P Katz; Edward H Yelin; Jinoos Yazdany Journal: Arthritis Care Res (Hoboken) Date: 2015-05 Impact factor: 4.794
Authors: Adam M Huber; Gulnara Mamyrova; Peter A Lachenbruch; Julia A Lee; James D Katz; Ira N Targoff; Frederick W Miller; Lisa G Rider Journal: Arthritis Care Res (Hoboken) Date: 2014-05 Impact factor: 4.794
Authors: Laura Nuño-Nuño; Beatriz Esther Joven; Patricia E Carreira; Valentina Maldonado-Romero; Carmen Larena-Grijalba; Irene Llorente Cubas; Eva Gloria Tomero; María Carmen Barbadillo-Mateos; Paloma García De la Peña Lefebvre; Lucía Ruiz-Gutiérrez; Juan Carlos López-Robledillo; Henry Moruno-Cruz; Ana Pérez; Tatiana Cobo-Ibáñez; Raquel Almodóvar González; Leticia Lojo; María Jesús García De Yébenes; Francisco Javier López-Longo Journal: Rheumatol Int Date: 2017-09-02 Impact factor: 2.631
Authors: Vidya Limaye; Colin Luke; Graeme Tucker; Catherine Hill; Susan Lester; Peter Blumbergs; Peter Roberts-Thomson Journal: Rheumatol Int Date: 2012-07-26 Impact factor: 2.631