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PARIS -- Patients with Sjogren's syndrome, an autoimmune condition characterized by inflammation of the tear ducts and salivary glands, had more than double the heart attack risk seen in the general population, a researcher reported here.

Compared with matched controls, patients with Sjogren's syndrome had an incident rate ratio for myocardial infarction (MI) of 2.19 (95% CI 1.40-3.31), according to , of the University of British Columbia in Vancouver.

Avina-Zubieta and colleagues also found a nonsignificant trend toward increased stroke risk among patients with the condition, he reported at the annual .

Unlike many other rheumatologic conditions, little has been written about cardiovascular disease in Sjogren's syndrome, Avina-Zubieta said during a press briefing. So he and his colleagues conducted the first population-based retrospective study of 1,176 cases diagnosed in British Columbia between 1990 and 2010, matching each case for birth year, sex, and calendar year with controls.

They identified 28 cases of MI among the Sjogren's patients and 138 among the controls, with incidence rates of 7.7 versus 3.4 per 1,000 patient-years.

After adjustment for cardiovascular and medication risk factors, the multivariable rate ratio for MI was 2.36 (95% CI 1.48-3.78) for patients with Sjogren's syndrome.

They also looked at the risk over time and found that MI risk was almost four times higher during the first year after diagnosis (RR 3.6, 95% CI 1.6-7.3), "with inflammation being the main driver of risk during early disease," he said.

The risk then decreased over time, with a rate ratio of 1.9 (95% CI 0.6-5) after 5 years.

Avina-Zubieta's group then analyzed risks for stroke and found a trend toward increase in the Sjogren's patients, "which probably will be significant if we follow the patients longer," he said.

There were 19 cerebrovascular accidents among cases and 139 among controls, with rates of 5.1 and 3.4 per 1,000 patient-years. For stroke, the unadjusted and multivariable incident rate ratios were 1.49 (95% CI 0.87-2.42) and 1.64 (95% CI 0.96-2.82).

"Cardiovascular disease in Sjogren's syndrome shouldn't be considered a comorbidity associated with the disease. It should be thought of as a direct complication," he said.

"The main message of this study was the importance of surveillance for cardiovascular risk among patients with Sjogren's syndrome and emphasis on modification of those risks," he concluded.

The moderator of the press briefing, president-elect of the European League Against Rheumatism , of Charite Hospital in Berlin, noted that cardiovascular risk among these patients has been "grossly neglected and underappreciated, and we need to better understand the risks and complications of this disorder."

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