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Incidence of aortic aneurysm, dissection, or rupture among patients with polymyalgia rheumatica and giant cell

Kylie Carlson1, Mahmut Kaymakci2, Sebastian E Sattui3

  • 1Medical College of Wisconsin, Milwaukee, WI, USA.

Seminars in Arthritis and Rheumatism
|March 24, 2025
PubMed
Abstract

Insights

Patients with polymyalgia rheumatica (PMR) have a similar risk of aortic complications as the general population. The risk is lower compared to giant cell arteritis (GCA), suggesting no need for routine aortic screening in PMR patients without GCA features.

Area of Science:

  • Rheumatology
  • Vascular Medicine
  • Epidemiology

Background:

  • Polymyalgia rheumatica (PMR) may involve subclinical large vessel vasculitis.
  • Comparing aortic complication incidence in PMR and giant cell arteritis (GCA) to the general population is crucial for understanding disease associations.

Purpose of the Study:

  • To investigate and compare the incidence of aortic complications (aneurysm, dissection/rupture) in patients with PMR and GCA against a matched general population cohort.
  • To determine if PMR patients require screening for aortic inflammation.

Main Methods:

  • Retrospective cohort study using the TriNetX database (2000-2024) with PMR and GCA patients identified by diagnostic codes and corticosteroid use.
  • Matched general population controls (1:3 ratio) were included.
  • Cox proportional cause-specific hazard models calculated adjusted hazard ratios (aHR) with PMR as the referent.

Main Results:

  • Incidence rates per 1,000 person-years: GCA (11.69), PMR (6.78), general population (5.09).
  • GCA patients had a significantly higher risk of aortic complications compared to PMR patients (aHR 1.87).
  • PMR patients showed a similar risk to the general population (aHR 0.95).

Conclusions:

  • PMR patients exhibit a similar risk of large vessel complications as the general population.
  • The risk of aortic complications is lower in PMR than in GCA.
  • Routine screening for aortic inflammation is not supported for PMR patients without GCA features.
Keywords:
AortaAortic aneurysmAortic dissectionAortic ruptureGiant cell arteritisLarge vessel vasculitisPolymyalgia rheumatica

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