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Vascular calcification in patients with large-vessel vasculitis compared to patients with hyperlipidemia

Shubhasree Banerjee1, Mohammadhadi Bagheri2, Veit Sandfort2

  • 1Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 10 Center Drive, Building 10, Rm 216G, Bethesda, MD 20892, USA.

Seminars in Arthritis and Rheumatism
|October 16, 2018
PubMed

Insights

Large-vessel vasculitis (LVV) shows less coronary artery calcification than hyperlipidemia (HLD). However, LVV patients have greater overall vascular calcification in large arteries, influenced by risk factors like age and prednisone use.

Area of Science:

  • Cardiovascular Medicine
  • Rheumatology
  • Radiology

Background:

  • Vascular calcification is a hallmark of both atherosclerosis and large-vessel vasculitis (LVV).
  • Distinguishing calcification patterns in LVV versus hyperlipidemia (HLD) is crucial for understanding disease mechanisms and risk.
  • Identifying risk factors for vascular calcification in LVV is essential for patient management.

Purpose of the Study:

  • To compare the location and extent of vascular calcification in patients with LVV (Giant Cell Arteritis and Takayasu's Arteritis) and HLD.
  • To identify risk factors associated with vascular calcification in patients with LVV.

Main Methods:

  • Non-contrast computed tomography (CT) was used to assess vascular calcification in the aorta, branch vessels, and coronary arteries.
  • Calcification was quantified using the Agatston score across 14 arterial territories.
  • Multivariate linear regression analyses identified associations between risk factors and total calcification scores.

Main Results:

  • Coronary artery calcification prevalence was lower in LVV (GCA 35%, TAK 9%) compared to HLD (67%).
  • Total Agatston scores were significantly higher in GCA patients (median 3260) versus HLD patients (median 460).
  • Age, type of vasculitis, and prednisone use were significantly associated with vascular calcification in LVV.

Conclusions:

  • Despite lower coronary artery calcification, LVV is associated with a greater burden of total vascular calcification in large arteries compared to HLD.
  • Both traditional and disease-specific risk factors contribute to vascular calcification in LVV.
  • These findings highlight distinct calcification profiles in LVV and HLD, underscoring the importance of tailored risk assessment.
Abstract

Keywords:
Cardiovascular diseaseGiant cell arteritisHyperlipidemiaLarge-vessel vasculitisTakayasu's arteritisVascular calcification

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