{
  "abstract": "Introduction Introduction: Interest in defining the cardiovascular (CV) burden of systemic sclerosis (SSc) has progressively increased. This is part of a broader research trend on cardiovascular risk in rheumatic diseases, that has primarily focused on rheumatoid arthritis (RA). FDA provided a definition of major cardiac adverse event (MACE) and WHO a definition of cardiovascular diseases (CVD). Nonetheless, there is considerable variability regarding the denotation of CV outcomes and exposures among both observational studies and clinical trials (RCT). This leads to a lack of reproducibility that hinders future research and possible interventions.This systematic review investigates the variability of CV definitions in the scientific literature in SSc and RA.Material and Methods Methods: A systematic search among papers on SSc and RA was performed from PubMed, Embase and Cochrane Central Library from Jan 2008 to May 2025. Literature screening and data extraction were independently performed by two researchers. We divided CV definitions into categories: ‘FDA MACE’, ‘WHO CVD’. ‘Other MACE definition’ and ‘other CVD definition’ if the authors called a composite endpoint MACE or CVD but it didn’t match FDA and WHO definitions. ‘Other CV events’ if the CV definitions didn’t fit into the above categories, ‘instrumental’ if the main endpoint was instrumental, ‘not defined’ if the authors didn’t specify their CV outcomes/exposures.Results Results: From an initial pool of 5246 studies, 361 were included in the final evaluation. Of these 333 were conducted on RA and only 32 were conducted on SSc, 4 studies investigated both diseases. ‘FDA MACE’ definition was employed in 46 papers on RA (13%) and 2 papers on SSc (6%), ‘WHO CVD’ in 17 (5%) papers on RA and 2 (6%) papers on SSc. An ‘other MACE definition’ and an ‘other CVD definition’ were used respectively in 23 (7%) and 26 (8%) papers on RA and in 3 (9%) and 0 papers on SSc. 114 (34%) papers on RA and 6 (19%) on SSc reported an ‘other CV event’, while an instrumental technique was used to assess CV outcomes in 87 (29%) papers on RA and in 19 (59%) papers on SSc. No RCT were conducted on SSc, 24 were written on RA (7.2% of 333).Conclusions Conclusions: Despite evidence that SSc entails a higher CV risk than RA, scientific literature on the matter (especially RCT) is scarce, and standard definitions of MACE and CVD are rarely applied. There is a need for standardization to increase reproducibility and ensure useful results.",
  "authors": [
    {
      "affiliations": [
        "Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy"
      ],
      "name": "Laura Pezzoni"
    },
    {
      "affiliations": [
        "Department of Rheumatology, IRCCS Ospedale Galeazzi SantAmbrogio, Milano, Italy",
        "Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milano, Italy"
      ],
      "name": "Silvia Sirotti"
    },
    {
      "affiliations": [
        "Department of Rheumatology, IRCCS Ospedale Galeazzi SantAmbrogio, Milano, Italy",
        "Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milano, Italy"
      ],
      "name": "Georgios Filippou"
    },
    {
      "affiliations": [
        "Department of Rheumatology, IRCCS Ospedale Galeazzi SantAmbrogio, Milano, Italy",
        "Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milano, Italy"
      ],
      "name": "Piercarlo Sarzi Puttini"
    },
    {
      "affiliations": [
        "Department of Rheumatology, IRCCS Ospedale Galeazzi SantAmbrogio, Milano, Italy",
        "Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milano, Italy"
      ],
      "name": "Greta Pellegrino"
    }
  ],
  "title": "P.149 Don’t count your chickens before they hatch! Analysis of cardiovascular definitions in studies on systemic sclerosis: a systematic literature review",
  "uid": "4c4decd4-efeb-5c7d-91d7-b51c4e74c89d"
}