Analysis of Takayasu's Arteritis as a Risk Factor for Acute Coronary Syndrome
Maria Emilia Romero Noboa1, Shilpa Arora2,3, Preeti Kansal4
1Department of Rheumatology, University of Alabama at Birmingham, Birmingham, AL.
Insights
Takayasu arteritis (TAK) independently increases the risk of acute coronary syndrome (ACS), similar to traditional cardiovascular factors. Physicians should be aware of this elevated ACS risk in TAK patients.
Area of Science:
- Cardiology
- Rheumatology
- Vascular Medicine
Background:
- Takayasu arteritis (TAK) is a rare vasculitis affecting major arteries, potentially leading to acute coronary syndrome (ACS).
- Understanding TAK's role as an ACS risk factor is crucial for patient management.
Purpose of the Study:
- To analyze Takayasu arteritis as an independent risk factor for acute coronary syndrome in a large US adult inpatient population.
Main Methods:
- Retrospective analysis of the 2016-2020 National Inpatient Sample (NIS) database.
- Multivariable logistic regression was used to assess the association between TAK, traditional cardiovascular risk factors, and ACS.
- Outcomes were reported as adjusted odds ratios (ORadj).
Main Results:
- Out of nearly 149 million hospitalizations, 3.28 million had ACS, with 180 cases also diagnosed with TAK (0.005%).
- Takayasu arteritis (ORadj 1.78) was independently associated with increased odds of ACS.
- Traditional risk factors like hyperlipidemia (ORadj 2.94) and nicotine dependence (ORadj 1.96) also showed significant associations.
Conclusions:
- Takayasu arteritis is an independent risk factor for acute coronary syndrome, comparable to established cardiovascular risk factors.
- Physicians should maintain a high index of suspicion for ACS in patients with Takayasu arteritis.
Introduction:
Takayasu's arteritis (TAK) is a rare chronic granulomatous vasculitis that primarily affects the aorta and its major branches but is also known to affect the coronary arteries. This involvement can result in acute coronary syndrome (ACS). This study aims to analyze TAK as an ACS risk factor in a US adult inpatient population.
Methods:
We performed a retrospective study of ACS in 2016-2020 National Inpatient Sample (NIS) database. TAK and traditional cardiovascular (CV) risk factors were included in a multivariable logistic regression analysis for an outcome of ACS. The results were reported as adjusted odds ratios (ORadj) with P values <.05 considered significant.
Results:
There were 148,767,786 adult hospitalizations in the 2016-2020 NIS database. Of the 3,282,749 hospitalizations with ACS, 180 (0.005%) had TAK. Multivariable analysis showed that age (ORadj 1.02), lowest income quartile (ORadj 1.03), diabetes (ORadj 1.19), hypertension (ORadj 1.06), hyperlipidemia (ORadj 2.94), nicotine dependence/tobacco use (ORadj 1.96), obesity (ORadj 1.21), and TAK (ORadj 1.78) were associated with a higher odds of ACS.
Conclusions:
Despite rare occurrence of concurrent ACS and TAK, we found TAK was independently associated with ACS similar to traditional CV risk factors. These results should alert physicians to the high risk of ACS in TAK inpatients.
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