{
  "abstract": "Introduction Cardiac involvement is a major cause of morbidity and mortality in systemic sclerosis (SSc). Autoantibodies may help identify patients at increased cardiovascular (CV) risk. This systematic review aimed to assess the predictive value of classical and emerging SSc-related autoantibodies for cardiac involvement and their integration with imaging and cardiac biomarkers.Material and Methods A comprehensive literature search was conducted in PubMed, Web of Science, Scopus, and the Cochrane Library up to 16 July 2025. Studies were included if they reported associations between specific autoantibodies and cardiac outcomes (e.g., myocardial fibrosis, conduction abnormalities, arrhythmias, ventricular dysfunction) in adult patients with SSc. Data extraction and quality assessment followed PRISMA 2020 guidelines. The review protocol was registered in PROSPERO (CRD420251107782).Results Anti-topoisomerase I antibodies were associated with myocardial fibrosis, subclinical systolic and diastolic dysfunction, elevated cardiac biomarkers, and pathological findings on cardiac magnetic resonance imaging. Anti-centromere antibodies were linked to conduction system abnormalities, particularly among older individuals. Anti-RNA polymerase III and anti-U3 ribonucleoprotein antibodies correlated strongly with arrhythmias and pericardial involvement. Novel autoantibodies, such as anti-heart antibodies and anti-intercalated disk antibodies, were linked to early myocardial injury, although their clinical utility requires further validation. Across studies, serological markers alone were insufficient to predict cardiac outcomes without concurrent imaging or biomarker evaluation.Conclusions Autoantibody profiling plays an important role in CV risk stratification in SSc. Combining serological testing with cardiac biomarkers and advanced imaging enhances early detection and supports individualized monitoring. Further longitudinal studies are needed to validate predictive models and optimize patient outcomes.",
  "authors": [
    {
      "affiliations": [
        "Division of Rheumatology and Clinical Immunology University Hospital Split, Split, Croatia",
        "School of Medicine, University of Split, Split, Croatia"
      ],
      "name": "Mislav Radic"
    },
    {
      "affiliations": [
        "Division of Rheumatology and Clinical Immunology University Hospital Split, Split, Croatia"
      ],
      "name": "Petra Simac Prizmic"
    },
    {
      "affiliations": [
        "Cardiovascular Disease Department, University Hospital of Split, Split, Croatia"
      ],
      "name": "Tina Becic"
    },
    {
      "affiliations": [
        "Department of Neurology, University Hospital of Split, Split, Croatia"
      ],
      "name": "Hana Dogas"
    },
    {
      "affiliations": [
        "Internal Medicine Department, Gastroenterology Division, Split, Croatia",
        "Faculty of Health Sciences, University of Split, Split, Croatia"
      ],
      "name": "Ivana Jukic"
    },
    {
      "affiliations": [
        "School of Medicine, University of Split, Split, Croatia",
        "Cardiovascular Disease Department, University Hospital of Split, Split, Croatia"
      ],
      "name": "Damir Fabijanic"
    },
    {
      "affiliations": [
        "School of Medicine, University of Split, Split, Croatia",
        "Department of Internal Medicine, Division of Nephrology, Dialysis and Arterial Hypertension, Split, Croatia"
      ],
      "name": "Josipa Radic"
    }
  ],
  "title": "P.043 Predictive value of classical and emerging autoantibodies for cardiac dysfunction in systemic sclerosis: systematic review",
  "uid": "c4e37282-d155-5519-b654-c73d52203ddb"
}