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Published on: February 8, 2019

Risk factors for cranial ischemic complications in giant cell arteritis

Gideon Nesher1, Yaakov Berkun, Michal Mates

  • 1From Shaare-Zedek Medical Center (GN, MM, MS), Jerusalem; Bikur-Cholim Hospital (YB), Jerusalem; School of Public Health, Hadassah Medical Center (MB), Jerusalem; Hadassah-Hebrew University Medical School (AR), Jerusalem; and Sapir Medical Center (RN), Kfar-Saba, Israel.

Medicine
|March 19, 2004
PubMed

Insights

Giant cell arteritis (GCA) patients with transient cerebro-ophthalmic ischemic episodes (COIEs) and without systemic symptoms face higher risks of cranial ischemic complications (CICs). Early CICs and later COIEs predict new CICs during follow-up.

Area of Science:

  • Rheumatology
  • Neurology
  • Ophthalmology

Background:

  • Cranial ischemic complications (CICs) are significant manifestations of giant cell arteritis (GCA).
  • CICs can occur at presentation or develop later, even with steroid treatment.
  • Identifying risk factors is crucial for managing GCA and preventing CICs.

Purpose of the Study:

  • To identify risk factors for CICs at GCA presentation.
  • To determine risk factors for new-onset CICs during GCA follow-up.
  • To review existing literature on GCA-related CICs.

Main Methods:

  • Retrospective chart review of 175 GCA patients.
  • Follow-up data analyzed for 166 patients.
  • Multivariate analysis to assess associations between CICs and clinical variables.

Main Results:

  • At presentation, 24.6% of patients had CICs. Risk factors included transient cerebro-ophthalmic ischemic episodes (COIEs) and male sex. Systemic symptoms were protective.
  • During follow-up, 8.4% developed new CICs. Risk factors were prior CICs and new COIEs. Low-dose aspirin showed a protective effect.
  • Patients with COIEs and lacking systemic symptoms were at higher risk for presenting CICs.

Conclusions:

  • Transient COIEs and absence of systemic symptoms are key risk factors for presenting CICs in GCA.
  • Previous CICs and developing COIEs during follow-up increase the risk of late-onset CICs.
  • Low-dose aspirin may offer protection against late-onset CICs in GCA patients.

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