Cardiovascular Risk and Acute Coronary Syndrome in Giant Cell Arteritis: A Population‐Based Retrospective Cohort Study

Abstract

Objective We assessed the occurrence of acute coronary syndrome (ACS) in patients with giant cell arteritis (GCA) compared to subjects without GCA. Methods We retrospectively reviewed a population-based incidence cohort of Olmsted County, Minnesota residents with GCA diagnosed in 1950-2009. We compared this cohort with a cohort of patients without GCA of similar age, sex and calendar year from the same population. Results The study included 245 patients with GCA and 245 non-GCA subjects. Mean Framingham cardiovascular risk score was 30% (SD 19%) in GCA and 34% (SD 23%) in non-GCA (p=0.096) at incidence/index date. Diabetes mellitus was significantly less common in GCA than non-GCA at index date. Mean high-density lipoprotein was higher and triglycerides were lower and fewer patients were using lipid-lowering medications in the GCA cohort compared to the non-GCA at index date. During follow-up, no difference between the two cohorts was noted in overall rate of ACS events [hazard ratio (HR) 0.74; 95% confidence interval (CI) 0.44, 1.26]. Overall thrombosis in myocardial infarction (TIMI) scores were similar in both cohorts. Revascularization procedures were done less frequently in GCA than non-GCA subjects (19% vs. 50%; p=0.015). Post ACS hospital length of stays and complications were similar in both cohorts. Conclusion Multiple cardiovascular risk factors are more favorable at incidence of GCA. There is no overall increased risk of acute coronary syndromes in patients with GCA.

Rate of Comorbidities in Giant Cell Arteritis: A Population-based Study

“…However, the rate ratios compared with reference population were higher in the Canadian study. Udayakumar et al demonstrated no overall increased in the rate of acute coronary syndrome among patients with GCA (15). The association between GCA and coronary artery disease is unclear with varied findings among several population-based studies (13)(14)(15).…”

“…Udayakumar et al demonstrated no overall increased in the rate of acute coronary syndrome among patients with GCA (15). The association between GCA and coronary artery disease is unclear with varied findings among several population-based studies (13)(14)(15). Differences in case ascertainment of cases of GCA (study criteria vs. biopsy-proven GCA) may explain such variations.…”

Experience With Tocilizumab, an Interleukin 6 Inhibitor, Used for the Treatment of Giant Cell Arteritis With Severe Comorbidity

“…Риск ИБС был также по-вышен, но это повышение не достигало статистической значимости (1,20; 95% ДИ 1,00-1,44). По данным другого исследования, у больных ГКА не было выявлено повышения риска развития острого коро-нарного синдрома [22]. Ранее М. Durand и соавт.…”

Thrombotic and Thromboembolic Complications in Systemic Vasculitis

“…Одно из не-давних исследований полностью подтверждает эти данные, за исключением более высокой частоты заре-гистрированных инсультов (7 %) [44]. Любопытные результаты были получены в недавнем ретроспектив-ном исследовании [45]. Было отмечено, что риск раз-вития острого коронарного синдрома у больных гиган-токлеточным артериитом сопоставим с таковым у пациентов, не страдающих данным заболеванием; наряду с этим у больных гигантоклеточным артериитом ряд традиционных факторов риска, таких как сахарный диабет, оказывали протективное действие.…”