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Published on: February 4, 2021
Disease-specific factors associated with cardiovascular events in patients with Takayasu arteritis
Oh Chan Kwon1, Jung Hwan Park1, Yong-Beom Park1
1Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Insights
In Takayasu arteritis (TAK), type V vascular involvement increases cardiovascular event risk. Methotrexate use, however, is linked to a reduced risk of these events in TAK patients.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Vascular Biology
Background:
- Takayasu arteritis (TAK) is a rare, chronic inflammatory disease affecting large arteries, primarily the aorta and its branches.
- Cardiovascular events are a significant cause of morbidity and mortality in patients with TAK.
- Identifying specific factors that predict cardiovascular events is crucial for risk stratification and management.
Purpose of the Study:
- To investigate disease-specific factors associated with cardiovascular events in patients diagnosed with Takayasu arteritis.
- To determine the predictive value of vascular involvement patterns and treatment on cardiovascular outcomes.
Main Methods:
- Retrospective analysis of 207 patients with Takayasu arteritis (TAK) diagnosed between 2006 and 2019.
- Assessment of traditional cardiovascular risk factors and TAK-specific factors at baseline.
- Cox regression analysis was employed to evaluate the association between TAK-specific factors and incident cardiovascular events, adjusting for traditional risk factors.
Main Results:
- Cardiovascular events occurred in 19.8% of the studied TAK patients.
- Type V vascular involvement was significantly associated with an increased risk of cardiovascular events (adjusted Hazard Ratio [HR] 2.852).
- Methotrexate use was associated with a reduced risk of cardiovascular events (adjusted HR 0.515).
Conclusions:
- Type V vascular involvement is a key predictor of cardiovascular events in Takayasu arteritis patients.
- The use of methotrexate may confer a protective effect against cardiovascular events in this population.
- These findings highlight the importance of considering vascular involvement patterns and specific immunosuppressive therapies in managing cardiovascular risk in TAK.
Background:
To identify disease-specific factors associated with cardiovascular events in patients with Takayasu arteritis (TAK).
Methods:
Patients with TAK who fulfilled the American College of Rheumatology 1990 criteria for the classification of TAK and were followed up between 2006 and 2019 were included. Traditional cardiovascular risk factors and TAK disease-specific factors at the index date and incident cardiovascular events during the follow-up were retrospectively assessed. To estimate the risk of cardiovascular events according to TAK disease-specific factors, Cox regression analysis with adjustment for traditional cardiovascular risk factors was performed.
Results:
Of the total 207 patients with TAK, cardiovascular events occurred in 41 (19.8%) patients. Compared with patients who did not develop cardiovascular events, patients who developed cardiovascular events were older (38.5 ± 13.4 years vs. 43.6 ± 11.8 years, p = 0.028), more commonly had diabetes mellitus (6.6% vs. 19.5%, p = 0.029), had lower high-density lipoprotein cholesterol (57.3 ± 17.1 mg/dl vs. 51.2 ± 15.7 mg/dl, p = 0.040), more commonly had type V vascular involvement (33.1% vs. 63.4%, p 0.001), and less commonly received methotrexate (65.1% vs. 43.9%, p = 0.013). In Cox regression analysis, type V vascular involvement was significantly associated with increased risk of cardiovascular events (adjusted HR 2.852, 95% CI 1.474-5.518, p = 0.002), whereas the use of methotrexate was associated with reduced risk of cardiovascular events (adjusted HR 0.515, 95% CI 0.268-0.993, p = 0.047).
Conclusion:
Type V vascular involvement was associated with increased risk of cardiovascular events, while the use of methotrexate was associated with reduced risk of cardiovascular events, in patients with TAK.
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