Predictors of cardiovascular complications in patients with Takayasu’s arteritis: results of a retrospective study and analysis of autopsy materials
https://doi.org/10.15829/1728-8800-2019-5-90-97
Abstract
Aim. To evaluate the structure and predictors of vascular complications in Takayasu’s arteritis (TA) patients.
Material and methods. Overall 183 TA patients have been treated at the Sverdlovsk Regional Clinical Hospital № 1 during the period from 1979 to 2018. Besides, the results of 22 autopsies performed at the Sverdlovsk State Laboratory of Clinical Pathology at the same period of time.
Results. Retrospective analysis revealed that 72 of 183 TA patients had vascular complications. Predictors of vascular complications were: male gender (p=0,002), smoking (p=0,002), surgical intervention before the event (p=0,002), arterial hypertension at the disease onset (p=0,011), signs of coronaritis at the disease onset (p<0,001), headache at the disease onset (p=0,028). Autopsy data revealed 17 cases (77%) of arterial and veins thrombosis. Vascular events were the main cause of death in 82% of lethal cases. According to autopsy data, 21 patients (96%) had atherosclerotic lesions of arterial wall (spots, stripes, plaques) combined with TA specific lesions.
Conclusion. TA patients are a high-risk group of severe and potentially lethal cardiovascular events and require thorough attention to prophylactic measures.
About the Authors
I. E. BorodinaRussian Federation
Yekaterinburg
A. A. Popov
Russian Federation
Yekaterinburg
L. A. Shardina
Russian Federation
Yekaterinburg
G. G. Salavatova
Russian Federation
Yekaterinburg
A. V. Spirin
Russian Federation
Yekaterinburg
References
1. Насонов Е. Л., Насонова В. А. Ревматология. Национальное руководство. М.: Геотар Медиа, 2010: 539-67. ISBN: 978-5-97041650-1.
2. Borodina IE, Popov AA, Salavatova GG, Shardina LA. Takayasu’s arteritis: the retrospective analysis of patients from the Ural population. Bulletin of RSMU. 2019;(1):93-101. doi:10.24075/brsmu.2019.012.
3. Стрижаков Л. А., Моисеев С. В., Коган Е. А. и др. Факторы риска атеросклероза и клинико-морфологические сопоставления при системных васкулитах. Научно-практическая ревматология. 2012;53(4):18-23.
4. Wan J. Cardiac Manifestation of Takayasu Arteritis [abstract]. Arthritis Rheumatol.2015; 67 (suppl 10). https://acrabstracts.org/abstract/cardiacmanifestation-of-takayasu-arteritis/. Accessed April 24, 2019.
5. Alibaz-Oner F, Koster MJ, Unal AU, et al. Assessmemt of the frequency of cardiovascular risk factors in patients with Takayasus arteritis. Rheumatology (Oxford). 2017;56(11):1939-44. doi:10.1093/rheumatology/kex300.
6. Thygesen K, Alpert JS, Jaffe AS, et al. Third universal definition of myocardial infarction. Eur Heart J. 2012;33:2551-67. doi:10.1093/eurheartj/ehs184.
7. Da Silva TF, Levy-Neto M, Bonfá E, et al. High prevalence of metabolic syndrome in Takayasu arteritis: increased cardiovascular risk and lower adiponectin serum levels. J Rheumatol. 2013;40(11):1897-904. doi:10.3899/jrheum.130162.
8. Lee GY, Jang SY, Ko SM, et al. Cardiovascular manifestations of Takayasu arteritis and their relationship to the disease activity: analysis of 204 Korean patients at a single center. Int J Cardiol 2012;159(1):14-20. doi:10.1016/j.ijcard.2011.01.094.
9. . Liu Q, Dang A, Lv N, et al. Anaemia and low body mass index are associated with increased cardiovascular disease in patients with Takayasu arteritis. Clin Exp Rheumatol. 2016;34(3):16-20.
10. Wang X, Dang A, Lv N, et al. High-sensitivity C-reactive protein predicts adverse cardiovascular events in patients with Takayasu arteritis with coronary artery involvement. Clin Rheumatol. 2016;35(3):679-84. doi:10.1007/s10067-015-2873-6.
11. Jordan NP, Bezanahary H, D'Cruz DP. Increased risk of vascular complications in Takayasu's arteritis patients with positive lupus anticoagulant. Scand J Rheumatol. 2015;44(3):211-4. doi:10.3109/03009742.2014.964305.
12. Wang X, Dang A, Lv N, et al. Inflammation Is Associated With Platelet Coagulation Function Rather Than Enzymatic Coagulation Function in Patients With Takayasu Arteritis. Int Heart J. 2017;13:589-92 . doi:10.1536/ihj.16-533.
13. De Souza AWS, Machado NP, Pereira VM, et al. Antiplatelet therapy for the prevention of arterial ischemic events in Takayasu arteritis. Circ J. 2010;74(6):1236-41. doi:10.1253/circj.CJ-09-0905.
14. Couture P, Chazal T, Rosso C, et al. Cerebrovascular events in Takayasu arteritis: a multicenter case-controlled study. J Neurology. 2018;265(4):757-63. doi:10.1007/s00415-018-8744-8.
15. Commarmond C, Biard L, Lambert M, et al. French Takayasu Network. LongTerm Outcomes and prognostic factors of complicates in Takayasu Arteritis: a multicenter study of 318 patients. Circulation. 2017;19(136):1114-22. doi:10.1161/QRCULATIONAHA.116.027094.
Review
For citations:
Borodina I.E., Popov A.A., Shardina L.A., Salavatova G.G., Spirin A.V. Predictors of cardiovascular complications in patients with Takayasu’s arteritis: results of a retrospective study and analysis of autopsy materials. Cardiovascular Therapy and Prevention. 2019;18(5):90-97. (In Russ.) https://doi.org/10.15829/1728-8800-2019-5-90-97