PT - JOURNAL ARTICLE AU - Valérie Leclair AU - John Svensson AU - Ingrid E. Lundberg AU - Marie Holmqvist TI - Acute coronary syndrome in idiopathic inflammatory myopathies: a population-based study AID - 10.3899/jrheum.181248 DP - 2019 Mar 15 TA - The Journal of Rheumatology PG - jrheum.181248 4099 - http://www.jrheum.org/content/early/2019/03/11/jrheum.181248.short 4100 - http://www.jrheum.org/content/early/2019/03/11/jrheum.181248.full AB - Objective Evidence suggest an increased risk of cardiovascular diseases including acute coronary syndrome (ACS) in idiopathic inflammatory myopathies (IIM). The aim of this study was to investigate the risk of ACS in an incident IIM cohort compared to the general Swedish population. Methods A cohort of 655 incident IIM individuals and 6813 general population comparators were identified from national registries. IIM subjects were diagnosed from 2002 to 2011. Followup started at IIM diagnosis and corresponding date in the general population. ACS, cardiovascular comorbidities and cardiovascular risk factors were defined using ICD codes. Incidence rates including 95% confidence intervals (CI) were calculated. Cox proportional hazards models were used to compare the risk of ACS in IIM patients and the general population. The competing risk of death was accounted for using competing risk regression models. Results The incidence rate of ACS in IIM was higher than in the general population particularly within the first year of diagnosis and in older individuals. The overall ACS incidence rate (95% CI) in IIM was 15.6 (11.7-20.4) per 1000 person-years with a hazard ratio (95% CI) of 2.4 (1.8-3.2) compared with the general population. When accounting for the competing risk of death, the risk of ACS in IIM remained increased with a cumulative incidence of 7% at 5 years compared to 3.3% in the general population. Conclusion IIM individuals are at higher risk of ACS particularly within the first year after diagnosis.