Background Takayasu's arteritis (TA) is a rare and heterogeneous disease that can be difficult to diagnose.
Objectives In this study we distinguish clinical characteristics in the different groups with TA and aimed to improve the diagnosis ability of this disease in different people.
Methods We retrospectively analyzed the clinical manifestations and laboratory and angiographic findings of 53 TA patients divided into groups by age and by gender.
Results Ratio of incidence in males and females was 1:4; mean age at onset was (35 ± 11) years in males and (28 ± 11) years in females. In 17% of patients, at onset was over the age of 40. The most common symptom at onset was chest pain and reduced glomerular filtration rate (GFR) in males [7 (63.6%) vs. 12 (28.6%), P=0.031; 8 (72.7%) vs. 14 (33.3%), P=0.034], especially in young males [age≤40 years, 5 (62.5%) vs. 8 (22.2%), P=0.024; 7 (87.5%) vs. 12 (33.3%), P=0.006]. Significantly more male patients, especially males over the age of 40, had multi-vessel involvement [10 (90.9%) vs. 24 (57.1%), P=0.038; 2 (66.7%) vs. 0, P=0.033]. Significantly more young males had aortic insufficiency [5 (62.5%) vs. 8 (22.2%), P=0.024]. Pulselessness [2 (66.7%) vs. 0, P=0.03] and radial artery weakening [2 (66.7%) vs. 0, P=0.03] were found in more males over 40 years of age at onset. There were no differences in laboratory data between males and females. Chest pain [13 (29.5%) vs. 6 (66.7%), P=0.031] and fever [0 vs. 1 (11.1%), P=0.027]occurred significantly more often in patients over the age of 40., and patients over 40 years of age at onset had significantly less renal artery [1 (11.1%) vs. 21 (47.7%), P=0.042], abdominal aortic [0 vs. 16 (38.1%), P=0.030], and multi-vessel involvement [2 (22.2%) vs. 32 (72.7%), P=0.004]. Patients over 40 years of age were rarer in type V [1 (11.1%) vs. 22 (50%), P=0.032)] while more common in type IIa [3 (33/3%) vs. 4 (9.1%), P=0.050] than young ones. Multivariate analysis showed that thoracic aortic involvement was an independent risk factor for developing hypertension (OR =3.918, 95% confidence interval [CI] 1.616–1566.185, P =0.026), and ascending aortic involvement was an independent risk factor for both aortic insufficiency (OR =3.674, 95% CI 2.734–567.621, P =0.007) and aneurysm formation (OR =7.255, 95% CI 7.255 ∼ 1,628,614; P =0.044).
Conclusions Patients with disease at onset after age 40 are more likely to present with chest pain and fever and only rarely have renal artery, abdominal aortic or multi-vessel involvement. Males are likely to present with multi-vessel involvement and reduced GFR, and these differences are more prominent in young males, who are more likely to develop aortic insufficiency. Aortic stenosis was an independent risk factor for hypertension, while ascending aortic involvement was an independent risk factor for aortic valvular insufficiency and aneurysm formation. Aortic valve lesion and ascending aorta involvement may play reciprocal role to aggravates destructions of each other and induce chest pain.
Disclosure of Interest None declared