Systemic Sclerosis (Also) Discriminates on Basis of Ethnicity

Blanco I, Mathai S, Shafiq M, et al.Severity of Systemic Sclerosis-Associated Pulmonary Arterial Hypertension in African Americans. Medicine (2014) 93: 177–185. doi: 10.1097/MD.0000000000000032

African Americans (AA) with systemic sclerosis (SSc) have a worse prognosis than Americans of European descent.

This study focused on the difference with regard to pulmonary comorbidities. It found that AA patients with pulmonary arterial hypertension (PAH) were more likely to present with severe PAH, to have diffuse SSc, and to have poorer survival odds.

The researchers studied 160 consecutive SSc patients with PAH diagnosed by right heart catheterization. The cohort included 29 Americans of African descent and 131 Americans of European descent. They had similar baseline characteristics,  except for increased prevalence of diffuse SSc among the AA patients.

AA patients had worse functional class, higher brain natriuretic peptide, more depressed right ventricular function, a trend toward lower 6-minute walk distance, and worse hemodynamics. Kaplan-Meier survival estimates for AA and European descent patients were 62% vs 73% at 2 years and 26% vs 44% at 5 years, respectively.