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THU0292 Risk Factors Associated with Cranial Ischemic Complications in Patients with Biopsy-Proven Giant Cell Arteritis
  1. O.M. Olivas,
  2. M. Martin,
  3. M. Galindo,
  4. I. Mateo,
  5. P.E. Carreira
  1. Department of Rheumatology, Hospital 12 de Octubre, Madrid, Spain

Abstract

Background Giant cell arteritis (GCA) is the most frequent vasculitis diagnosed in people over 50 years. Involvement of branches from the internal carotid and vertebral arteries could cause cranial ischemic complications (CIC), as visual loss or ischemic stroke, leading to severe disability. Low inflammatory response, lack of systemic symptoms and traditional cardiovascular risk factors have been suggested as independent risk factors for CIC. It has been also described that previous use of low-dose aspirin might prevent CIC events, although the evidence in this field is scarce

Objectives To analyze the differences in clinical presentation of patients with biopsy-proven GCA who develop or not CIC, and to evaluate the potential protective effect of pre-treatment with aspirin on CIC development

Methods Patients with biopsy-proven GCA diagnosed at a single University Hospital between 1992 and 2014 were selected. Demographic and clinical characteristics at GCA diagnosis, and previous cardiovascular risk factors and treatments were obtained from the charts. CIC was defined as: 1) visual loss, attributable to anterior ischemic optic neuropathy or retinal arterial occlusion, and 2) ischemic stroke, occurred at diagnosis or within 4 weeks after. Comparisons between patients with or without CIC were done by bivariate and multivariate binary logistic regression analysis. Statistical significance was defined as p<0.05

Results The group included 120 patients, 68.3% f, 31.7% m, mean age at GCA diagnosis 77,85±6,79 y. Twenty seven (22,5%) presented with CIC: 16 patients suffered visual loss, 11 had a stroke and 2 had both. Comparative analysis between patients with and without CIC is shown in table 1. In univariate analysis, the presence of fever was less frequent in patients with CIC, but ESR, CRP and haemoglobin levels were similar in both groups. Statin use, but not other cardiovascular risk factors or treatments, was significantly more frequent in patients with CIC. Previous aspirin or anticoagulant use was not different between patients with or without CIC. These results were confirmed in multivariate analysis.

Conclusions In our series of biopsy-proven GCA patients, previous use of aspirin is not associated with less incidence of CIC. Previous use of statins, perhaps as a surrogate marker of cardiovascular risk, is associated with the development of CIC in our patients

References

  1. Nesher G, Berkun Y, et. al. Medicine (Baltimore). 2004 Mar;83(2):114-22

  2. Martínez-Taboada VM, Lόpez-Hoyos M,et al. Autoimmun Rev. 2014 Aug;13(8):788-94.

Disclosure of Interest None declared

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