Giant cell arteritis-related stroke in a large inception cohort: A comparative study

Area of Science:

• Neurology
• Rheumatology
• Vascular Medicine

Background:

• Giant cell arteritis (GCA) can lead to stroke, a rare but severe complication.
• Early recognition of GCA-related stroke is crucial for timely intervention and improved outcomes.

Purpose of the Study:

• To compare features of GCA-related stroke with GCA without stroke and other stroke types.
• To identify diagnostic markers for GCA-related stroke to facilitate earlier diagnosis.

Main Methods:

• Retrospective analysis of 19 GCA-related stroke patients within a larger GCA cohort.
• Comparison with control groups: 541 GCA patients without stroke and 40 patients with typical stroke.
• Logistic regression and survival analyses (Kaplan-Meier, log-rank test) were employed.

Main Results:

• GCA-related stroke patients exhibited more comorbidities and aortitis but less headache and scalp tenderness.
• Independent predictors for GCA-related stroke included absence of anterior circulation involvement, external carotid ultrasound (ECU) abnormalities, and elevated C-reactive protein (CRP) levels (>3 mg/dL).
• GCA-related stroke patients had significantly decreased early survival compared to controls.

Conclusions:

• External carotid ultrasound (ECU) findings and C-reactive protein (CRP) levels are key indicators for GCA-related stroke.
• Prompt assessment of these factors can expedite diagnosis, improve prognosis, and shorten diagnostic delays in GCA-related stroke.
• These findings aid clinicians in recognizing and managing this critical condition more effectively.