SYSTEMATIC REVIEW article
Front. Cardiovasc. Med.
Sec. General Cardiovascular Medicine
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1598590
This article is part of the Research TopicAutoimmune Diseases and Cardiovascular HealthView all 6 articles
Systematic Review and Meta-Analysis of Cardiovascular Associated Biomarkers in Adults with Asymptomatic Autoimmune Diseases
Provisionally accepted
- 1First Clinical Medical College, Guangdong Medical University, Zhanjiang, Guangdong Province, China
- 2School of Basic Medicine, Guangdong Medical University, Dongguan, Guangdong Province, China
- 3Department of Rehabilitation, The people’s Hospital of Gaoming District of Foshan City, Guangdong Province, China, Foshan, China
- 4Anhui Medical University, Hefei, Anhui Province, China
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Introduction: Cardiovascular disease (CVD) remains a leading cause of death. Autoimmune patients face heightened CVD risk due to chronic inflammation and immune dysregulation. This systematic review and meta-analysis aim to synthesize current evidence on the predictive value of advanced or novel autoimmune biomarkers for the occurrence of CVD in middle-aged patients with autoimmune diseases and without cardiovascular history or symptoms. Methods: Abstract was registered prospectively (PROSPERO CRD42024611894) and conducted an advanced, MeSH-based search (2004–2025) for studies on autoimmune diseases in adults (18–65) without prior CVD, in various databases. Pooled adjusted hazard ratios were generated using Stata 18, assessing heterogeneity (Cochran's Q, I²), publication bias (funnel plot, Egger's test), and risk of bias (ROBINS-I), with sensitivity analysis performed to confirm robustness. Result: A comprehensive search in PubMed, Embase, and Medline yielded 3,975 records (after removing 237 duplicates), and after screening 2,488 titles/abstracts and 896 full texts, 69 studies (34 for meta-analysis) with 46,493 participants were included after excluding 188 with pre-existing CVD and 117 with insufficient data. High-sensitivity C-reactive protein (hs-CRP) was consistently associated with elevated CVD risk despite high heterogeneity and potential publication bias. Similarly, lupus anticoagulant, sVCAM-1, and antiphospholipid antibodies demonstrated strong predictive associations. In contrast, rheumatoid factor, anti-CCP, ADMA, homocysteine, NT-proBNP, anti-dsDNA, and TNF-alpha showed borderline significance or inconsistent results. These findings underscore the potential of select inflammatory and immune markers for enhancing CVD risk stratification and guiding targeted prevention strategies. Conclusion: Integrating these biomarkers with traditional risk factors may enable early detection of subclinical atherosclerosis in autoimmune patients, pending further research.
Keywords: autoimmune disease, cardiovascular disease, Advanced Biomarkers, prediction, Atherosclerosis
Received: 23 Mar 2025; Accepted: 08 Sep 2025.
Copyright: © 2025 U, He, Yang and Ramteke. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhiwei He, hezhiwei@gdmu.edu.cn
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