Coronary artery lesions in Takayasu arteritis

Area of Science:

• Cardiovascular Medicine
• Rheumatology
• Vascular Inflammation

Background:

• Takayasu arteritis (TAK) is a large-vessel granulomatous vasculitis, predominantly affecting young women.
• The incidence and impact of coronary artery disease (CAD) in TAK patients remain understudied.
• Coronary artery lesions (CAL) in TAK can significantly increase patient morbidity and mortality.

Purpose of the Study:

• To review and synthesize current literature on the prevalence, characteristics, and management of coronary artery lesions in Takayasu arteritis.
• To highlight the clinical significance of CAL in TAK, particularly in pediatric and young adult populations.
• To emphasize the importance of early diagnosis and timely intervention for CAL in TAK.

Main Methods:

• A comprehensive literature review was conducted using PubMed and Scopus databases.
• The search covered publications from 2003 to 2023.
• Keywords included "Takayasu arteritis", "coronary angiography", "myocardial revascularization", "coronary artery disease", "angina pectoris", and "myocardial infarction".

Main Results:

• Coronary artery lesions (CAL) are not uncommon in TAK, especially in children and young individuals.
• CAL in TAK commonly affect the ostia and proximal coronary segments, leading to stenosis or occlusion.
• These lesions manifest as stable or unstable CAD, myocardial infarction, and can contribute to sudden death.

Conclusions:

• TAK is a significant cause of CAL, particularly in younger patients, more so than previously recognized.
• Cardiovascular death due to CAL in TAK is a considerable risk.
• Prompt diagnosis and management of TAK with CAL are essential to prevent severe complications and improve patient prognosis.