SPC365

Clustering Inflammation to Stratify Cardiovascular Risk in Autoimmune Disease

Session: Sessão de Posters 03 - Cardio-oncologia e doença sistémica: onde o cancro encontra o coração
Speaker: Rita Louro

Congress: CPC 2026
Topic: K. Cardiovascular Disease In Special Populations
Theme: 30. Cardiovascular Disease in Special Populations
Subtheme: 30.12 Autoimmune/Chronic Inflammatory Disorders and Heart Disease
Session Type: Posters Eletrónicos
FP Number: ---
Authors: Rita Louro; Marta Figueiredo; Maria Santos Fialho; Maria de Belém Coelho; Flávio Quadrado; Ana Teresa Vieira; Gustavo Sá Mendes; Margarida Jacinto

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-family:&quot;Aptos Display&quot;,sans-serif"><span style="color:black">Background:</span></span></strong>&nbsp;<span style="font-size:13.5pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif"><span style="color:black">Inflammation is recognised as a determinant of cardiovascular risk. Patients with autoimmune diseases, due to chronic systemic inflammation, carry an excess cardiovascular burden. However, the characterisation of inflammatory profiles and their impact on cardiovascular outcomes remains poorly defined. This study aimed to identify inflammatory clusters in autoimmune patients and assess their association with major adverse cardiovascular events (MACE).</span></span></span></span></span></span></p>

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<span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-family:&quot;Aptos Display&quot;,sans-serif"><span style="color:black"><strong><span style="font-family:&quot;Aptos Display&quot;,sans-serif">Methods:</span></strong></span></span>&nbsp;<span style="font-size:13.5pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif"><span style="color:black">We conducted a cross-sectional study including 388 patients followed at an autoimmune diseases clinic during 2023. Cluster analysis based on erythrocyte sedimentation rate, C-reactive protein, and ferritin identified two groups: an inflammatory cluster and a control cluster. The primary endpoint was MACE, defined as a composite of death, stroke, heart failure, and acute/chronic coronary syndromes. Multivariable logistic regression adjusted for age, sex, hypertension, dyslipidaemia, diabetes, obesity, smoking, corticosteroid and DMARD use, and statin therapy was performed.</span></span></span></span></span></span></p>

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<span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-family:&quot;Aptos Display&quot;,sans-serif"><span style="color:black"><strong><span style="font-family:&quot;Aptos Display&quot;,sans-serif">Results:</span></strong></span></span>&nbsp;<span style="font-size:13.5pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif"><span style="color:black">Patients in the inflammatory cluster (n=52) were older (median 73 vs. 58 years, p&lt;0.05) and had significantly higher inflammatory markers. Traditional cardiovascular risk factors and lipid profiles were similarly distributed between groups. The prevalence of MACE was significantly higher in the inflammatory cluster compared with the control cluster (25.0% vs. 12.3%, p&lt;0.05). In multivariable analysis, the inflammatory cluster remained independently associated with a two-fold higher risk of MACE (OR 2.26, 95% CI 1.01&ndash;5.05, p=0.048), even after adjustment for age and conventional cardiovascular risk factors. Obesity was also associated with increased risk (OR 2.35, 95% CI 1.04&ndash;5.32, p=0.040), while male sex was protective (OR 0.46, 95% CI 0.21&ndash;0.98, p=0.045). Statin therapy was strongly associated with MACE (OR 7.10, 95% CI 2.47&ndash;20.39, p&lt;0.001), likely reflecting treatment bias, as high-risk patients were treated. Other traditional cardiovascular risk factors referred in the methods were not independent predictors.</span></span></span></span></span></span></p>

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<span style="font-size:12pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif"><span style="color:black"><strong><span style="font-family:&quot;Aptos Display&quot;,sans-serif">Conclusions:</span></strong></span></span></span>&nbsp;<span style="font-size:13.5pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif"><span style="color:black">Inflammatory clusters identify autoimmune patients with substantially increased cardiovascular risk, independent of age and conventional risk factors. These findings highlight systemic inflammation as an independent therapeutic target. More assertive anti-inflammatory strategies, combined with aggressive management of conventional risk factors, may improve outcomes in this population.</span></span></span></p>