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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis

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Risk factors for severe cranial ischaemic complications in giant cell arteritis

Alojzija Hočevar1,2, Rok Ješe1, Matija Tomšič1,2

  • 1Department of Rheumatology, University Medical Centre Ljubljana.

Rheumatology (Oxford, England)
|March 4, 2020
PubMed

Insights

Risk factors for severe cranial ischemic complications (sCIC) in Giant Cell Arteritis (GCA) include increasing age, jaw claudication, and smoking. Higher C-reactive protein (CRP) levels were found to decrease the risk of sCIC.

Area of Science:

  • Neurology
  • Rheumatology
  • Ophthalmology

Background:

  • Giant Cell Arteritis (GCA) is a systemic vasculitis that can lead to severe cranial ischemic complications (sCIC), including vision loss and stroke.
  • These complications significantly increase morbidity and mortality in GCA patients.

Purpose of the Study:

  • To identify the key risk factors associated with the development of sCIC in patients diagnosed with GCA.
  • To differentiate predictors for severe vision complications versus ischemic stroke within the GCA cohort.

Main Methods:

  • A prospective analysis of 295 GCA patients diagnosed between September 2011 and August 2019.
  • Comparison of clinical and laboratory data between patients with and without sCIC, defined as severe vision complications or stroke.

Main Results:

  • Of 295 GCA patients, 61 (20.7%) developed sCIC.
  • Multivariable analysis revealed that increasing age (OR 1.08), jaw claudication (OR 3.43), and smoking (OR 1.92) were significant predictors of sCIC.
  • Higher C-reactive protein (CRP) levels were associated with a decreased risk of sCIC (OR 0.99).
  • Age and jaw claudication increased the risk of severe vision complications, while polymyalgia rheumatica, constitutional symptoms, and higher CRP decreased it.
  • Atrial fibrillation was the sole independent predictor of ischemic stroke.

Conclusions:

  • Increasing age, jaw claudication, and smoking are significant risk factors for sCIC in GCA.
  • Elevated CRP levels may confer a protective effect against sCIC in GCA patients.
  • Identifying these risk factors can aid in early detection and prevention strategies for GCA complications.
Abstract

Keywords:
giant cell arteritisrisk factorsstrokevision complications

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