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Clinically Apparent Arterial Thrombosis in Persons with Systemic Vasculitis.
Alexander Tsoukas1, Sasha Bernatsky1,2, Lawrence Joseph2,3
1Division of Rheumatology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada.
International Journal of Rheumatology
|July 18, 2017
Summary
Patients with primary systemic vasculitis have higher rates of arterial thrombotic events like heart attacks and strokes. Cardiovascular comorbidities are also increased, particularly in younger adults with polyarteritis nodosa.
Area of Science:
- Rheumatology
- Cardiology
- Epidemiology
Background:
- Primary systemic vasculitis is a group of rare autoimmune diseases characterized by inflammation of blood vessels.
- Arterial thrombotic events and cardiovascular comorbidities are significant concerns in these patients.
Purpose of the Study:
- To estimate the incidence rate of clinically apparent arterial thrombotic events (acute myocardial infarctions and cerebrovascular accidents) in patients with primary systemic vasculitis.
- To assess the associated comorbidities, including type 2 diabetes mellitus, dyslipidemia, and hypertension.
Main Methods:
- Utilized large cohort administrative data from Quebec, Canada.
- Identified patients with vasculitis, including polyarteritis nodosa (PAN) and granulomatosis with polyangiitis (GPA).
- Compared incidence rates of acute myocardial infarctions (AMIs) and cerebrovascular accidents (CVAs) to a general population comparator group.
Main Results:
- The AMI rate was substantially higher in males aged 18-44 with PAN (up to 268.1 events per 10,000 patient-years), approximately 30 times that of controls.
- CVA rates were also substantially higher, particularly in adults aged 45-65.
- Patients with vasculitis showed elevated incidences of diabetes, dyslipidemia, and hypertension compared to the general population.
Conclusions:
- Atherothrombotic rates are elevated in patients with primary systemic vasculitis.
- While cardiovascular comorbidities are increased, the significant rise in AMIs in young adults suggests a disease-specific factor requiring further research.
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