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Predictors of Cardiovascular Events in Patients With Takayasu Arteritis

Shiping He1, Zhan Rong2, Yanhong Wang3

  • 1Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, Beijing, China; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, China; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.

The Canadian Journal of Cardiology
|March 29, 2025
PubMed

Insights

Takayasu arteritis (TAK) patients face high cardiovascular event risk. Key predictors include delayed diagnosis, elevated ESR, and specific vascular conditions, enabling better risk prediction.

Area of Science:

  • Cardiovascular Medicine
  • Rheumatology
  • Vascular Biology

Background:

  • Takayasu arteritis (TAK) is a rare, chronic inflammatory disease affecting large arteries, primarily the aorta and its branches.
  • Cardiovascular events are a major cause of morbidity and mortality in patients with TAK.
  • Identifying risk factors and developing predictive models are crucial for managing TAK patients.

Purpose of the Study:

  • To identify factors associated with cardiovascular events in TAK patients.
  • To develop and validate a prediction model for 10-year cardiovascular event probability in TAK.
  • To provide a tool for personalized risk assessment and management strategies.

Main Methods:

  • Prospective enrollment of 702 TAK patients across 7 centers (July 2013 - March 2021).
  • Cox proportional hazard regression analysis to identify independent risk factors.
  • Model validation using Harrell's concordance index (C-index), Brier score, and calibration plots.

Main Results:

  • Cardiovascular events occurred in 13.4% of patients over a median follow-up of 67 months.
  • Independent risk factors identified: advanced age at diagnosis, diagnostic delay ≥ 3 years, pulselessness, pulmonary hypertension, aortic regurgitation, and elevated erythrocyte sedimentation rate (ESR) at disease onset.
  • The prediction model demonstrated good performance with an optimism-corrected C-index of 0.71 and a Brier score of 0.072.

Conclusions:

  • TAK patients are at significant risk for cardiovascular events.
  • Age, diagnostic delay, specific clinical/imaging findings (pulselessness, pulmonary hypertension, aortic regurgitation), and inflammatory markers (ESR) are key predictors.
  • The developed prediction model and nomogram can aid in estimating 10-year cardiovascular event risk in TAK.
Abstract

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