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Racial differences in stroke, blindness, and mortality among Black versus non-Black patients with giant cell
Jawad Muayad1, Elizabeth O Arogundade2, Sanjana Jaiswal2
1College of Medicine, Texas A&M University, Houston, TX, United States.
Insights
Black patients with giant cell arteritis (GCA) had higher risks of stroke and emergency department (ED) visits but lower risks of ischemic optic neuropathy (ION). Further research is needed to understand these racial differences in GCA outcomes.
Area of Science:
- Rheumatology
- Vascular Biology
- Health Disparities
Background:
- Giant cell arteritis (GCA) is a systemic vasculitis affecting large arteries.
- Understanding racial variations in GCA outcomes is crucial for equitable patient care.
Purpose of the Study:
- To investigate potential racial differences in vascular, visual, and systemic outcomes among Black and non-Black patients diagnosed with GCA.
- To compare the incidence of major adverse events following GCA diagnosis between racial groups.
Main Methods:
- Retrospective cohort study utilizing the TriNetX global database.
- Propensity score matching was employed to create comparable cohorts of Black and non-Black GCA patients (n=3,022 each).
- Analysis assessed risks of stroke, ischemic optic neuropathy (ION), visual defects, emergency department (ED) visits, myocardial infarction (MI), aortic aneurysm/dissection, and death at 6-month and 1-year follow-ups.
Main Results:
- Black patients exhibited a higher likelihood of stroke at 6 months (HR 1.33) and 1 year (HR 1.38).
- Black patients also had increased ED visits at 6 months (HR 1.29) and 1 year (HR 1.29).
- Conversely, Black patients showed a lower likelihood of ION at 6 months (HR 0.60) and 1 year (HR 0.59).
Conclusions:
- Racial disparities exist in GCA outcomes, with Black patients facing elevated risks for stroke and ED visits.
- Black patients demonstrated a reduced risk for ischemic optic neuropathy (ION).
- Further investigation is warranted to elucidate the factors driving these racial differences and to promote equitable GCA management.
Objective:
To explore potential racial differences in vascular, visual, and systemic outcomes among Black and non-Black patients with giant cell arteritis (GCA).
Design:
A retrospective cohort study using the TriNetX global database.
Participants:
30,513 patients diagnosed with GCA, including 3 068 Black (10.1%) and 27,445 non-Black (89.9%) patients. After propensity score matching, 3 022 patients were included in each group.
Methods:
A propensity score-matched analysis was conducted to compare the risks of stroke, ischemic optic neuropathy (ION), visual defects/blindness, emergency department (ED) visits, myocardial infarction (MI), aortic aneurysm/dissection, and death at 6-month and 1-year follow-ups. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated.
Results:
Black patients appeared to have a higher likelihood of stroke at 6 months (HR 1.33, 95% CI: 1.07-1.65) and 1 year (HR 1.38, 95% CI: 1.13-1.69), as well as more ED visits at 6 months (HR 1.29, 95% CI: 1.17-1.42) and 1 year (HR 1.29, 95% CI: 1.18-1.41) compared to non-Black patients. In contrast, Black patients had a lower likelihood of ION at 6 months (HR 0.60, 95% CI: 0.43-0.85) and 1 year (HR 0.59, 95% CI: 0.42-0.82). No notable differences were observed in MI, visual defects/blindness, aortic aneurysm/dissection, or death.
Conclusions:
These findings suggest potential racial differences in GCA-related outcomes, with Black patients experiencing a higher likelihood of stroke and ED visits but a lower likelihood of ION. Further research is needed to better understand the underlying factors contributing to these differences and to ensure equitable care for all patients with GCA.
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