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Giant cell arteritis-related aortic dissection: A multicenter retrospective study

Hubert de Boysson1, Olivier Espitia2, Maxime Samson3

  • 1Department of Internal Medicine, Caen University Hospital, Avenue de la Côte de Nacre, Caen 14000, France; Normandy University, Caen, Unicaen, France.

Seminars in Arthritis and Rheumatism
|March 10, 2021
PubMed

Insights

Giant cell arteritis (GCA) patients with large-vessel vasculitis (LVV) are prone to aortic dissection. Aortic surgery significantly improves survival rates in these high-risk patients.

Area of Science:

  • Cardiovascular Medicine
  • Rheumatology
  • Vascular Surgery

Background:

  • Giant cell arteritis (GCA) is a systemic vasculitis that can affect large arteries, including the aorta.
  • Aortic dissection is a serious complication of GCA, potentially leading to significant morbidity and mortality.

Purpose of the Study:

  • To characterize the clinical features and outcomes of patients experiencing aortic dissection in the context of GCA.
  • To identify predictors of survival in patients with GCA-related aortic dissection.

Main Methods:

  • Retrospective analysis of a nationwide GCA network cohort.
  • Inclusion of patients with aortic dissection either preceding GCA diagnosis or during its follow-up.
  • Data collection on patient demographics, disease characteristics, treatment, and survival outcomes.

Main Results:

  • 46 patients with GCA-related aortic dissection were identified.
  • Aortic dissection occurred either at GCA diagnosis (21 patients) or during follow-up (25 patients).
  • Aortic surgery was performed in 59% of patients, with a survival rate of 85% among those operated on. Multivariate analysis identified aortic surgery as the sole predictor of survival (HR: 4.3; p=0.007).

Conclusions:

  • Patients with prior large-vessel vasculitis (LVV) have an increased risk of early aortic dissection and require vigilant aortic monitoring.
  • Aortic dissection carries a substantial mortality risk, with one-third of patients dying from the complication.
  • Surgical intervention for aortic dissection in GCA patients is associated with improved survival outcomes.
Abstract

Keywords:
Aortic dissectionAortitisGiant-cell arteritisLarge-vessel vasculitisSurgery

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