Systemic sclerosis & Raynaud's
Nailfold capillaroscopy as a predictor of major cardiovascular events and mortality in systemic sclerosis
Authors' conclusion
Avascular areas in baseline NFC are strong predictors of MCEs and mortality in SSc, whereas microhaemorrhages have a lower risk.
Study context
- Population
- Systemic sclerosis (SSc) patients diagnosed according to the 2013 ACR/EULAR criteria who underwent nailfold capillaroscopy (NFC) within one month of diagnosis
- Participants
- 360 patients
- Exposure
- Baseline NFC findings as predictors of major cardiovascular events (MCEs) and mortality
- Outcome
- MCEs and mortality
Methodological detailsobservational, multivariable analyses
- Observational
- Multivariable analyses
Main finding
As reported in the abstract
Independent predictors of MCEs (multivariable) · median follow-up 11.7 years
- MCE incidence
- 64 patients (17.8%)
- Diabetes mellitus, HR
- 2.37, p = 0.031
- ILD, HR
- 3.16, p < 0.001
- Avascular areas on baseline NFC, HR
- 2.24, p = 0.034
- Previous MCE, HR
- 3.89, p < 0.001
- Microhaemorrhages (protective trend), HR
- 0.55, p = 0.053
Observational data: associations, not effects.
Further findings
Independent predictors of all-cause mortality (multivariable) · median follow-up 11.7 years
- Overall mortality rate
- 21.1% (76 patients)
- Deaths attributed to SSc-related complications / MCEs / other causes
- 30.9% / 29.4% / 39.7%
- Age, HR
- 1.03, p = 0.039
- Disease duration, HR
- 0.81, p < 0.001
- Avascular areas, HR
- 2.09, p = 0.032
- Microhaemorrhages (protective), HR
- 0.35, p = 0.002
SSc-related mortality
- Avascular areas associated with poorer survival
- log-rank p-value <0.001
- Microhaemorrhages associated with better survival
- log rank p-value = 0.01
Baseline NFC findings
- Scleroderma NFC pattern
- 88%
- Early / active / late pattern
- 33.05% / 32.5% / 22.5%
- Giant capillaries
- 75.28%
- Microhaemorrhages
- 54.17%
- Avascular areas
- 38.6%
Original publication
Nailfold capillaroscopy as a predictor of major cardiovascular events and mortality in systemic sclerosis. Semin Arthritis Rheum. Published 5 October 2025. doi:10.
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