Assessing Cardiovascular and Metabolic Risks in Dermatomyositis Patients: A Retrospective Cohort Study

Dermatomyositis (DM) is an autoimmune inflammatory myopathy that has been associated with systemic conditions like cardiovascular diseases (CVD). However, the risk of developing these diseases and the causative mechanisms are poorly described. In our retrospective cohort study, we analyzed de-identified electronic health records (EHRs) from 67 U.S. healthcare organizations in the TriNetX Research Network to evaluate these associations. Patients with DM (ICD-10: M33.0, M33.1, M33.9) were compared to matched controls without DM. Propensity score matching was used to control for age, sex, race, and comorbidities. A total of 64,051 cases and 64,042 controls were included. DM conferred an increased risk of nonrheumatic aortic valve stenosis, atrial fibrillation, and type II diabetes mellitus, and a decreased risk of CKD, hyperlipidemia, and primary hypertension. No significant associations were found for ischemic heart disease, cerebral infarction, venous thromboembolism, heart failure, or cerebrovascular diseases. Overall, DM poses a heightened long-term risk for certain cardiovascular and metabolic diseases but appears less associated with CKD, hyperlipidemia and primary hypertension. Decreased renal and vascular comorbidity risks may reflect effective outpatient management or possible disease-specific pathophysiologic differences. These overall findings support the need for further research exploring the underlying mechanisms driving these associations. Additionally, early risk stratification and interdisciplinary care should be implemented in the management of DM, with particular focus on cardiovascular surveillance and diabetes prevention.