The Meta-analysis Of Risk Factors Of Dermatomyositis Or Polymyositis Associated Cardiac Involvements

Objective The risk factors of cardiac involvements in patients with dermatomyositis or polymyositis is investigated,for providing evidence of clinical prediction and early diagnosis of cardiac injury.Methods Pertinent literatures on risk factors of cardiac involvements in patients with dermatomyositis or polymyositis were retrieved from the databases such as Embase,PubMed,the Cochrane Library,VIP databases,Wanfang databases and China National Knowledge Infrastructure.The retrieveing time is set from building Library retrieval time to March 2020.According to the inclusion criteria and exclusion criteria document screening,the literatures about risk factors of ermatomyositis or polymyositis associated cardiac involvements were collected and the useful data were extracted.The results of the included studies were meta-analyzed using the Rev Man5.3 analysis software.Results A total of 9 references were included in this study,all of which were case-control studies.The total of samples were 1002 cases,385 cases in the dermatomyositis and polymyositis associated cardiac involvements group,and 617 cases in the dermatomyositis and polymyositis without cardiac involvements group.1.The analysis results of age,gender,course of disease and disease type:Older patients with DM/PM are more likely to have secondary cardiac involvements [MD=4.23,95%CI(2.13,6.34),P<0.05];There is no statistically significance in the risk of DM/PM associated cardiac involvements between female and male patients [OR=1.17,95%CI(0.87,1.59),P>0.05];The disease duration is not statistically significance between DM/PM patients with or without cardiac involvement [MD=9.07,95%CI(-4.41,22.55),P>0.05];The risks of cardiac involvements between DM patients and PM patients are not statistically significance [OR=0.92,95%CI(0.63,1.34),P>0.05].2.Analysis results of system involements : The differences of fever,secondary ILD between the DM/PM associated cardiac involvements group and the control group have statistically significance[OR=1.80,95%CI(1.25,2.59),P<0.05]、[OR=1.35,95%CI(0.88,2.87),P<0.05];The differences of muscle weakness,myalgia,Raynaud’s phenomenon,arthralgia,dysphagia between the cardiac involvement with DM/PM group and the control group are not statistically significant(P>0.05).3.Analysis results of laboratory tests: CK elevation was significantly different between DM/PM cardiac involvements group and non-cardiac involvements group[OR = 2.31,95% CI(1.35,3.93),P < 0.05];CK-MB elevation was significantly different between DM/PM cardiac involvements group and non-cardiac involvements group [OR = 36.74,95% CI(15.67,86.13),P < 0.05];CRP elevation and ESR elevation were not significantly different between DM/PM cardiac involvements group and non-cardiac involvements group(P>0.05).4.Analysis results of autoantibodies:The differences between ANA positive,anti-JO-1 antibody positive in cardiac involvements with DM/PM group and non-cardiac involvements with DM/PM group are statistically significant[OR=2.33,95%CI(1.43,3.79),P<0.05] 、 [OR=4.15,95%CI(2.54,6.75),P<0.05].That the differences of anti-SSA antibody 、 anti-SSB antibody are no statistically significant between the cardiac involvement with DM/PM group and it’s control group(P>0.05).Conclusions Advanced age,the positive of ANA,the positive of anti-jo-1antibody,the increase of CK,the increase of CK-MB,fever,secondary ILD were important risk factors for DM or PM associated cardiac involvements.