Systemic Sclerosis and Atherosclerosis: Potential Relations in the Cardiovascular Field

Atherosclerosis, a chronic inflammatory condition of medium and large blood vessels, poses a significant risk for cardiovascular morbidity and mortality globally. This review examines the interplay between atherosclerosis and autoimmune diseases, particularly focusing on Systemic Sclerosis (SSc) due to its unique pathophysiological features. The involvement of inflammatory mediators-such as cytokines and immune cells-in accelerating atherosclerosis is highlighted, with particular emphasis on how traditional cardiovascular risk factors interact with disease-specific mechanisms. Patients with SSc face an increased cardiovascular risk, largely driven by immune dysregulation and endothelial dysfunction, which contribute to both microvascular and macrovascular complications. While research suggests a potential link between SSc and accelerated atherosclerosis, findings remain inconsistent, warranting further investigation into the underlying mechanisms and implications for patient care. We also explore the roles of various immune cell types, including macrophages, B and T cells, and dendritic cells, in shaping the atherosclerotic process within the context of SSc. Importantly, pharmacological strategies are being considered to mitigate this risk. Aspirin, due to its combined anti-inflammatory and antiplatelet properties, has the potential to reduce atherosclerotic progression in SSc. Other agents, such as statins and hydroxychloroquine, are also emerging as promising therapies aimed at targeting inflammation and vascular damage. Given the rising cardiovascular-related mortality rates in SSc patients, there is a pressing need for targeted pharmacological interventions, alongside comprehensive disease management, to improve cardiovascular outcomes in this patient. © 2025 Anastasia V. Poznyak, et al.