Cardiovascular comorbidities are associated with dermatomyositis: A cross-sectional study in the All of Us Research Program

To the Editor: Dermatomyositis (DM), a rare idiopathic inflammatory myopathy with potential multisystemic complications, is associated with cardiovascular disease (CVD) and risk factors. However, prior CVD-related DM studies often combine heterogenous idiopathic inflammatory myopathy cohorts or focus on hospitalized patients, with variable results. 1 Linos E. Fiorentino D. Lingala B. Krishnan E. Chung L. Atherosclerotic cardiovascular disease and dermatomyositis: an analysis of the Nationwide Inpatient Sample survey. Arthritis Res Ther. 2013; 15: R7https://doi.org/10.1186/ar4135 Crossref PubMed Scopus (48) Google Scholar , 2 Lai Y.T. Dai Y.S. Yen M.F. et al. Dermatomyositis is associated with an increased risk of cardiovascular and cerebrovascular events: a Taiwanese population-based longitudinal follow-up study. Br J Dermatol. 2013; 168: 1054-1059https://doi.org/10.1111/bjd.12245 Crossref PubMed Scopus (32) Google Scholar , 3 Jung K.H. Kim H.J. Park W. et al. Incidence, survival, and risk of cardiovascular events in adult inflammatory myopathies in South Korea: a nationwide population-based study. Scand J Rheumatol. 2020; 49: 323-331https://doi.org/10.1080/03009742.2019.1707281 Crossref PubMed Scopus (5) Google Scholar , 4 Parraga Prieto C. Ibrahim F. Campbell R. Chinoy H. Galloway J. Gordon P. Similar risk of cardiovascular events in idiopathic inflammatory myopathy and rheumatoid arthritis in the first 5 years after diagnosis. Clin Rheumatol. 2021; 40: 231-238https://doi.org/10.1007/s10067-020-05237-7 Crossref PubMed Scopus (10) Google Scholar To date, no US-based database study has examined CVD in DM including both inpatient and outpatient encounters. Studies of other autoimmune disorders demonstrate a 1.5- to 4-fold higher CVD risk attributable to proinflammatory cytokines, autoantibodies, and/or immunomodulatory therapy side effects; similar mechanisms for increased CVD risk in DM are plausible. 5 Conrad N. Verbeke G. Molenberghs G. et al. Autoimmune diseases and cardiovascular risk: a population-based study on 19 autoimmune diseases and 12 cardiovascular diseases in 22 million individuals in the UK. Lancet. 2022; 400: 733-743https://doi.org/10.1016/S0140-6736(22)01349-6 Abstract Full Text Full Text PDF PubMed Scopus (117) Google Scholar Our study evaluates CVD comorbidities in DM using the National Institutes of Health's (NIH) All of Us Research Program, an innovative, diverse, and large biomedical data resource encompassing US adults.