Background Accelerated atherosclerosis associated with chronic inflammation is one of the major complications of systemic inflammatory diseases. Takayasu arteritis (TAK) is a rare, systemic large-vessel vasculitis predominantly affecting the aorta and its major branches. The prevalence of atherosclerotic risk factors and cardiovascular (CV) disease in patients with TAK has not been well defined.
Objectives The purpose of this study was to assess the frequency of CV risk factors and the incidence of CV events (CVE) in patients with TAK.
Methods Patients fullfilling the American College of Rheumatology criteria for TAK from Mayo Clinic, Rochester, USA and Marmara University, Istanbul, Turkey were included in this retrospective cohort study. Data on cardiovascular risk factors at the time of TAK diagnosis and incident CVE during follow-up were abstracted from the medical records. Patients with TAK were compared to age, sex and calendar year–matched controls from the same geographic region without TAK. The 2008 Framingham 10-year general cardiovascular risk score (FRS) was used for the evaluation of CV risk at the time of TAK incidence/index date. For patients without lipid profiles, the office-based FRS, which does not require lipid values, was computed according to previously published algorithms.
Results A total of 175 patients with TAK and 175 non-TAK controls were included in the study (115 from Mayo Clinic, 60 from Marmara University for each group). Among patients age ≥30 years at index date (107 TAK,109 non-TAK), complete data to calculate FRS were available in 93 (87%) TAK and 91 (83%) non-TAK subjects. Hypertension diagnosis and lipid lowering treatment were significantly more frequent in the TAK group compared to non-TAK). Prior to the incidence/index date, the occurrence of CVE was significantly higher in the TAK group The overall Framingham 10-year CV risk score was significantly higher in the TAK group compared to non-TAK at incidence/index date (Table 1).)After excluding patients with prevalent CVE, 18 TAK and 3 non-TAK patients developed CVE during a mean follow-up of 7.4 years in TAK and 7.9 years in non-TAK groups. The cumulative incidence of CVE was 16.4% at 10 years in TAK group vs. 6.0% in non-TAK group and the risk of CVE was increased among patients with TAK (hazard ratio: 4.52; 95% CI: 1.29, 15.78 adjusted for age, sex and country).
Conclusions CV risk factors are more common in patients with TAK, and the Framingham 10-year cardiovascular risk score is higher in patients with TAK at the time diagnosis compared to non-TAK subjects of similar age and sex. The cumulative incidence of CVE was also significantly higher during follow-up in the TAK group. Patients with TAK should undergo careful assessment of CV risk factors, and an aggressive risk modification approach is warranted.
Disclosure of Interest None declared