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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
Published on: February 8, 2019
Ischemic heart disease in patients from Northwest Spain with biopsy proven giant cell arteritis. A population based
Miguel A Gonzalez-Gay1, Gerardo Rubiera, Angela Piñeiro
1Division of Rheumatology, Hospital Xeral-Calde, c) Dr. Ochoa s/n, 27004 Lugo, Spain. miguelaggay@hotmail.com
Insights
Giant cell arteritis (GCA) patients in Lugo, Spain, show a slightly elevated risk of ischemic heart disease (IHD) mortality compared to the general population. However, GCA patients with IHD face significantly higher mortality than those without IHD.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Epidemiology
Background:
- Giant cell arteritis (GCA) is a systemic vasculitis affecting large arteries, with potential cardiovascular complications.
- Ischemic heart disease (IHD) is a significant cause of morbidity and mortality worldwide.
- Understanding IHD risk in GCA patients is crucial for clinical management.
Purpose of the Study:
- To determine the incidence, mortality, and predictors of ischemic heart disease (IHD) in patients with biopsy-proven giant cell arteritis (GCA).
- To compare IHD mortality in GCA patients with the general Spanish population.
Main Methods:
- Retrospective study of biopsy-proven GCA patients diagnosed between 1981 and 2001 in Lugo, Spain.
- Survival analysis was employed to assess mortality and predictors.
- Hazard ratios and standardized mortality ratios (SMR) were calculated.
Main Results:
- 19% of GCA patients developed IHD, with an incidence of 12.6/1000 person-years.
- The standardized mortality ratio (SMR) for IHD in GCA patients was 1.62.
- Mortality was significantly higher in GCA patients with IHD (HR 2.81).
- Predictors of IHD included age, hypertension, and abnormal temporal artery findings.
Conclusions:
- IHD mortality in Lugo's GCA patients is comparable to the Spanish population aged 50+.
- GCA patients who develop IHD have a substantially increased mortality risk.
- Early identification of IHD predictors in GCA is vital for improved patient outcomes.
Objective:
To assess the incidence, mortality, and predictors of ischemic heart disease (IHD) in patients from the Lugo region of Northwest Spain with biopsy-proven giant cell arteritis (GCA).
Methods:
Retrospective study of patients with biopsy-proven GCA diagnosed from 1981 to 2001 at the single hospital for a population of 250,000 people. A survival analysis was performed. Hazard ratios and standardized mortality ratio (SMR) as well as predictors of IHD in patients with biopsy-proven GCA were also assessed.
Results:
Nineteen (9%) of the 210 patients with biopsy-proven GCA diagnosed during the period of study had IHD. The incidence of IHD in patients with GCA was 12.6/1000 person-years at risk (95% CI 6.9-21.0). During the study period 1981-2000 the population aged > or = 50 years in Lugo was roughly 100,000, and the mortality rate due to IHD in patients with GCA for that population was 8/100,000. The SMR in patients with GCA due to IHD was 1.62 (95% CI 0.70-3.20). Mortality in patients with GCA who had IHD was higher than in those patients without IHD (age and sex adjusted hazard ratio 2.81, 95% CI 1.51-5.21; p = 0.001). Age (hazard ratio 1.15), hypertension (hazard ratio 2.51), and abnormal temporal artery on physical examination (hazard ratio 0.36) at the time of diagnosis of GCA were the best predictors of IHD over the followup period in patients with biopsy-proven GCA.
Conclusion:
Our observations suggest that mortality due to IHD in patients from Lugo with GCA is not much higher than that reported in the Spanish population aged 50 years and older. However, mortality in patients with GCA with IHD is higher than in GCA patients without IHD.
