Background: Systemic sclerosis (SSc), a chronic autoimmune disease characterized by progressive fibrosis and vascular abnormalities, poses significant cardiovascular risks for affected individuals. Among these, subclinical atherosclerosis has gained increasing attention as a critical contributor to morbidity and mortality in SSc. Intima-media thickness (IMT) of the carotid arteries, measured through non-invasive imaging techniques, serves as a reliable surrogate marker for early atherosclerotic changes and a predictor of cardiovascular events. In recent years, a growing body of evidence has sought to elucidate the extent and clinical significance of increased IMT in patients with SSc compared to healthy controls.

Objectives: This study aims to evaluate carotid intima-media thickness (IMT) in patients with systemic sclerosis (SSc) through an updated meta-analysis. By synthesizing data from existing literature, the objective is to determine the extent of subclinical atherosclerosis in SSc, identify influencing factors, and assess its clinical significance in cardiovascular risk stratification.

Methods: A systematic review of PubMed, Scopus and Cochrane of studies comparing CIMT in SSc patients and controls was conducted. Effect sizes were pooled using a random-effects model, and heterogeneity was assessed via I² and Tau² statistics. A funnel plot evaluated publication bias.

Results: Data from 18 studies encompassing 1,864 participants (Figure 1) revealed a statistically significant increase in CIMT in SSc patients (Cohen’s d = 1.13, 95% CI 0.18–2.08, p = 0.02). Heterogeneity was substantial (I² = 98%, p < 0.01), highlighting variability in study populations and methodologies. The funnel plot showed several studies outside the pseudo confidence intervals.

Conclusion: This updated meta-analysis confirms significantly increased CIMT in SSc patients, advocating for intensified cardiovascular monitoring and preventative strategies in SSc management.

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Acknowledgements: NIL.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.