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Symptomatic aortitis at giant cell arteritis diagnosis: a prognostic factor of aortic event

Olivier Espitia1, Gauthier Blonz2, Geoffrey Urbanski3

  • 1Department of Internal Medicine, CHU Nantes, 1 place Alexis Ricordeau, 44093, Nantes, France. olivier.espitia@chu-nantes.fr.

Arthritis Research & Therapy
|January 8, 2021
PubMed

Insights

Giant cell arteritis (GCA) patients with aortitis symptoms at diagnosis or GCA relapse face a higher risk of aortic complications like aneurysms and dissections. Early identification of these factors is crucial for managing GCA aortitis.

Area of Science:

  • Cardiovascular Medicine
  • Rheumatology
  • Vascular Biology

Background:

  • Giant cell arteritis (GCA) frequently involves the aorta, potentially leading to severe complications such as aneurysms and dissections.
  • Predictive factors for these aortic complications in GCA patients remain largely unidentified.
  • Understanding these factors is critical for proactive patient management and risk stratification.

Purpose of the Study:

  • To investigate factors associated with the risk of aortic complications in a cohort of patients diagnosed with GCA aortitis.
  • To identify potential predictors for the occurrence or worsening of aortic structural abnormalities.

Main Methods:

  • Retrospective collection of data from 171 GCA aortitis patients across five hospitals (1998-2019).
  • Analysis included clinical features, diagnosis via CT or 18 FDG PET, and follow-up for aortic complications.
  • Multivariate analysis was employed to identify independent predictive factors.

Main Results:

  • Aortitis symptoms at diagnosis were present in 32% of patients.
  • Aortic complications, including aneurysms and dissections, occurred in a significant proportion of patients after a median follow-up of 38 months.
  • Aortitis symptoms at diagnosis (HR 6.64) and GCA relapse (HR 3.62) were independently associated with aortic complications.

Conclusions:

  • The presence of aortitis symptoms at GCA diagnosis is a significant predictor of future aortic complications.
  • GCA relapse also emerged as an independent risk factor for aortic complications.
  • These findings highlight the importance of monitoring patients with GCA aortitis, especially those with initial symptoms or disease relapse.
Abstract

Keywords:
AneurysmAortic dissectionAortitisGiant cell arteritisPrognosis

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