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Cardiac Involvement in Granulomatosis with Polyangiitis
Lucy McGeoch1, Simon Carette1, David Cuthbertson1
1From the Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario, Canada; Health Informatics Institute, University of South Florida, Tampa, Florida; Center for Vasculitis Care and Research, Cleveland Clinic, Cleveland, Ohio, USA; Division of Rheumatology, McMaster University, Hamilton, Ontario, Canada; Division of Rheumatology, University of Utah, Salt Lake City, Utah; Division of Rheumatology, University of Pennsylvania, Philadelphia; Division of Rheumatology, University of Pittsburgh, Pennsylvania; The Vasculitis Center, Section of Rheumatology, and the Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts; Division of Rheumatology, Johns Hopkins University, Baltimore, Maryland; Division of Pulmonary and Critical Care Medicine, and the Division of Rheumatology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.L. McGeoch, MD; S. Carette, MD, Division of Rheumatology, Mount Sinai Hospital; D. Cuthbertson, MS, Health Informatics Institute, University of South Florida; G.S. Hoffman, MD, Center for Vasculitis Care and Research, Cleveland Clinic; N. Khalidi, MD, Division of Rheumatology, McMaster University; C.L. Koening, MD, Division of Rheumatology, University of Utah; C.A. Langford, MD, Center for Vasculitis Care and Research, Cleveland Clinic; C.A. McAlear, MA, Division of Rheumatology, University of Pennsylvania; L. Moreland, MD, Division of Rheumatology, University of Pittsburgh; P.A. Monach, MD, PhD, The Vasculitis Center, Section of Rheumatology, and the Clinical Epidemiology Unit, Boston University School of Medicine; P. Seo, MD, Division of Rheumatology, Johns Hopkins University; U. Specks, MD, Division of Pulmonary and Critical Care Medicine; S.R. Ytterberg, MD, Division of Rheumatology, Mayo Clinic College of Medicine; P.A. Merkel, MD, MPH, Division of Rheumatology, University of Pennsylvania; C. Pagnoux, MD, MSc, MPH, Division of Rheumatology, Mount Sinai Hospital.
Insights
Cardiac involvement in granulomatosis with polyangiitis (GPA) is rare, affecting 3.3% of patients in a North American cohort. This cardiac complication did not increase relapse rates or premature death.
Area of Science:
- Rheumatology
- Cardiology
- Immunology
Background:
- Granulomatosis with polyangiitis (GPA) is a rare autoimmune vasculitis.
- Cardiac involvement in GPA can be a serious complication.
- Data on the frequency and outcomes of cardiac disease in GPA is limited.
Purpose of the Study:
- To determine the frequency of cardiac involvement in a North American cohort of GPA patients.
- To compare the clinical characteristics and outcomes of GPA patients with and without cardiac involvement.
- To assess the association between cardiac involvement and disease relapse or mortality.
Main Methods:
- Analysis of patients from the Vasculitis Clinical Research Consortium Longitudinal Study of GPA.
- Comparison of demographic and clinical characteristics between patients with and without GPA-related cardiac involvement.
- Evaluation of relapse rates and mortality in relation to cardiac involvement.
Main Results:
- Cardiac involvement was identified in 3.3% of 517 GPA patients.
- No significant differences were found in demographics, ANCA positivity, or relapse rates between groups.
- Cardiac involvement was not associated with a higher rate of relapse or premature death.
Conclusions:
- Cardiac involvement in GPA is infrequent and presents heterogeneously.
- In this cohort, GPA-related cardiac disease did not correlate with increased relapse or mortality.
- Further research may elucidate specific risk factors and management strategies for cardiac involvement in GPA.
Objective:
To determine frequency and outcomes of granulomatosis with polyangiitis (GPA)-related cardiac disease in a North American GPA cohort.
Methods:
Analysis was done of all patients in the Vasculitis Clinical Research Consortium Longitudinal Study of GPA. Demographic and clinical characteristics of patients with and without GPA-related cardiac involvement were compared.
Results:
Of 517 patients with GPA, 3.3% had cardiac involvement. No differences were observed between patients with or without cardiac involvement in terms of demographics, antineutrophil cytoplasmic antibody positivity, or relapse rate.
Conclusion:
Cardiac involvement in GPA is rare and heterogeneous. In this cohort, cardiac involvement was not associated with a higher rate of relapse or premature death.
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