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A large cohort study suggests that the use of vasodilators and aspirin (ASA) in systemic sclerosis (SSc) may yield favorable cardiovascular outcomes.
Among 601 SSc patients followed since December 2012, they found that 24% received no vasodilators and 76% were on vasodilators ((ie, calcium channel blockers and/or ACE inhibitors or angiotensin II receptor blockers or combinations). Of the latter 89/453 were on either endothelin receptor antagonists or PDE5 inhibitors or prostanoids (aspirin).
With a total of 914 patient-years of follow-up, they observed 12 ventricular arrhythmias, 5 Q waves, 40 cardiac blocks, 6 pacemaker implantations and 19 reduced LVEF and/or congestive heart failure (CHF) events.
Vasodilator therapy was associated with a lower risk of ventricular arrhythmias (p=0.03).
Low-dose acetylsalicylic acid (ASA) also had a lower risk of cardiac blocks, Q waves and/or pacemaker implantation (p=0.02).
Active disease was associated with worse cardiac outcomes, including LVEF <55%, CHF, cardiac blocks, Q waves and pacemaker implantation (p=0.05).
Vasodilators and ASA may have a cardiovascular protective effect in systemic sclerosis patients.