Symptomatic aortitis at giant cell arteritis diagnosis: a prognostic factor of aortic event.
Aneurysm
Aortic dissection
Aortitis
Giant cell arteritis
Prognosis
Journal
Arthritis research & therapy
ISSN: 1478-6362
Titre abrégé: Arthritis Res Ther
Pays: England
ID NLM: 101154438
Informations de publication
Date de publication:
07 01 2021
07 01 2021
Historique:
received:
03
10
2020
accepted:
13
12
2020
entrez:
8
1
2021
pubmed:
9
1
2021
medline:
22
6
2021
Statut:
epublish
Résumé
Giant cell arteritis (GCA) is frequently associated with aortic involvement that is likely to cause life-threatening structural complications (aneurysm, dissection). Few studies have investigated the occurrence of these complications, and no predictive factor has been identified so far. The aim of this study was to investigate factors associated with the risk of aortic complications in a cohort of GCA aortitis. Data of all patients managed with aortitis (CT or 18 FDG PET) at the diagnosis of GCA in five hospitals from May 1998 and April 2019 were retrospectively collected. Clinical features were compared according to the presence of aortitis symptoms. The predictive factors of occurrence or aggravation of aortic structural abnormalities were investigated. One hundred and seventy-one patients with GCA aortitis were included; 55 patients (32%) had symptoms of aortitis (dorsal/lumbar/abdominal pain, aortic insufficiency) at diagnosis. The median follow-up was 38 months. Aortic complications occurred after a median time of 32 months. There were 19 new aortic aneurysms or complications of aneurysm and 5 dissections. Survival without aortic complication was significantly different between the symptomatic and non-symptomatic groups (Log rank, p = 0.0003). In multivariate analysis the presence of aortitis symptoms at diagnosis (HR 6.64 [1.95, 22.6] p = 0.002) and GCA relapse (HR 3.62 [1.2, 10.9] p = 0.02) were factors associated with the occurrence of aortic complications. In this study, the presence of aortitis symptoms at the diagnosis of GCA aortitis and GCA relapse were independent predictive factors of occurrence of aortic complications during follow-up.
Sections du résumé
BACKGROUND
Giant cell arteritis (GCA) is frequently associated with aortic involvement that is likely to cause life-threatening structural complications (aneurysm, dissection). Few studies have investigated the occurrence of these complications, and no predictive factor has been identified so far. The aim of this study was to investigate factors associated with the risk of aortic complications in a cohort of GCA aortitis.
METHODS
Data of all patients managed with aortitis (CT or 18 FDG PET) at the diagnosis of GCA in five hospitals from May 1998 and April 2019 were retrospectively collected. Clinical features were compared according to the presence of aortitis symptoms. The predictive factors of occurrence or aggravation of aortic structural abnormalities were investigated.
RESULTS
One hundred and seventy-one patients with GCA aortitis were included; 55 patients (32%) had symptoms of aortitis (dorsal/lumbar/abdominal pain, aortic insufficiency) at diagnosis. The median follow-up was 38 months. Aortic complications occurred after a median time of 32 months. There were 19 new aortic aneurysms or complications of aneurysm and 5 dissections. Survival without aortic complication was significantly different between the symptomatic and non-symptomatic groups (Log rank, p = 0.0003). In multivariate analysis the presence of aortitis symptoms at diagnosis (HR 6.64 [1.95, 22.6] p = 0.002) and GCA relapse (HR 3.62 [1.2, 10.9] p = 0.02) were factors associated with the occurrence of aortic complications.
CONCLUSION
In this study, the presence of aortitis symptoms at the diagnosis of GCA aortitis and GCA relapse were independent predictive factors of occurrence of aortic complications during follow-up.
Identifiants
pubmed: 33413605
doi: 10.1186/s13075-020-02396-5
pii: 10.1186/s13075-020-02396-5
pmc: PMC7792092
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
14Références
J Rheumatol. 2015 Jul;42(7):1213-7
pubmed: 25877501
J Rheumatol. 2020 Jan;47(1):108-116
pubmed: 30877210
Arthritis Rheum. 2003 Dec;48(12):3522-31
pubmed: 14674004
Medicine (Baltimore). 2014 Jul;93(5):194-201
pubmed: 25181312
Autoimmun Rev. 2018 Apr;17(4):391-398
pubmed: 29427822
Rev Med Interne. 2016 Mar;37(3):154-65
pubmed: 26833145
Arthritis Rheum. 1994 Oct;37(10):1539-47
pubmed: 7864947
Medicine (Baltimore). 2011 May;90(3):186-193
pubmed: 21512412
J Autoimmun. 2019 Sep;103:102283
pubmed: 31130367
Medicine (Baltimore). 2004 Nov;83(6):335-341
pubmed: 15525845
Autoimmun Rev. 2016 Jun;15(6):571-6
pubmed: 26903476
Arthritis Rheum. 2008 May 15;59(5):670-6
pubmed: 18438900
Rheumatology (Oxford). 2015 Mar;54(3):463-70
pubmed: 25193809
Medicine (Baltimore). 2016 May;95(19):e3524
pubmed: 27175649
Arthritis Care Res (Hoboken). 2018 Sep;70(9):1406-1411
pubmed: 29266882
Ann Rheum Dis. 2013 Dec;72(12):1989-94
pubmed: 23253927
Scand J Rheumatol. 2006 May-Jun;35(3):233-6
pubmed: 16766372
Presse Med. 2019 Sep;48(9):956-967
pubmed: 31327542
Ann Rheum Dis. 2020 Jan;79(1):19-30
pubmed: 31270110
Arthritis Rheum. 1990 Aug;33(8):1129-34
pubmed: 1975175
Ann Rheum Dis. 2012 Jul;71(7):1170-6
pubmed: 22267328
Ann Rheum Dis. 2018 May;77(5):636-643
pubmed: 29358285
J Rheumatol. 2012 Nov;39(11):2157-62
pubmed: 22984271