Development of aortic valve stenosis in myeloperoxidase antineutrophil cytoplasmic antibody-associated vasculitis with renal involvement.

Degenerative aortic valve stenosis (AS) is a chronic progressive disease that resembles atherosclerosis development. Antineutrophil cytoplasmic antibody-associated vasculitis (AAV) is reportedly associated with accelerated atherosclerosis. This study aimed to examine the development of AS in patients with myeloperoxidase-AAV (MPO-AAV) with renal involvement at more than 1 year after the onset of vasculitis. We performed a retrospective review of clinical records of MPO-AAV patients with renal involvement without AS at the onset of vasculitis who were treated in three hospitals and three dialysis clinics. The study included 97 MPO-AAV patients with renal involvement and 230 control patients with chronic kidney disease (CKD). Among them, 64 patients had AS. The prevalence rates of AS were 28.9% and 15.7% in MPO-AAV and control patients, respectively (p = 0.006). The multivariable logistic regression analysis showed that MPO-AAV, dialysis dependence, and hypertension were independently associated factors for AS. In MPO-AAV patients, systolic blood pressure was positively significantly associated with AS, whereas glucocorticoid dose of induction therapy was negatively significantly associated. The use of cyclophosphamide tended to be negatively associated with AS. The survival rate was significantly lower for patients with AS than for those without AS. The AS prevalence rate was significantly higher in MPO-AAV patients at more than 1 year after the onset of vasculitis than in control CKD patients. Therefore, regular monitoring of echocardiography during MPO-AAV treatment is suggested.

Déclaration de conflit d'intérêts

I have read the journal's policy and have reported potential conflicts of interest outside the present work: M Hasegawa received lecture fees from Takeda Pharmaceutical Co., Ltd., Sanofi Co., Ltd., Mitsubishi Tanabe Pharma Co., Ltd., Chugai Pharmaceutical Co., Ltd. and Sumitomo Dainippon Pharma Co., Ltd. D Inaguma received lecture fees from Ono Pharmaceutical Co., Ltd. and Kyowa Kirin Co., Ltd.. Y Yuzawa received consigned research fund from Kyowa Kirin Co., Ltd. and Japan Tobacco Inc. and research support grants from Asahi Kasei Medical Co., Ltd., Astellas Pharma Inc., Baxter Ltd., Bayer Yakuhin Ltd., Chugai Pharmaceutical Co., Ltd., Kissei Pharmaceutical Co., Ltd., Ono Pharmaceutical Co., ltd., Otsuka Pharmaceutical Co., Ltd., Pfizer Japan Inc., Sumitomo Dainippon Pharma Co., Ltd., Teijin Pharma Limited., Terumo Co., and Torii Pharmaceutical Co., Ltd.. N Tsuboi received the consigned research fund from Kyowa Kirin Co., Ltd. and Novartis Pharma K.K. and research support grants from Otsuka Pharmaceutical Co., Asahi Kasei Medical Co., Ltd., Baxter Ltd., Bayer Yakuhin, Ltd., Chugai Pharmaceutical Co., Ltd., and Torii Pharmaceutical Co., Ltd.. There are no other relevant declarations related to employment, consultancy, patents, products in development or marketed products associated with this research to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials.