Background Behçet's disease (BD) is a chronic inflammatory disease affecting various size of arteries and veins. Coronary artery disease (CAD), a life-threatening condition, is rarely reported in patients BD.
Objectives To investigate the clinical characteristics of BD patients complicated with CAD, and to elucidate the potential risk factors of CAD in BD patients.
Methods We retrospectively reviewed all the medical records of BD patients who were admitted to our institute from 2001 to 2016. CAD was defined as aneurysm, stenosis and (or) occlusion of coronary arteries confirmed by angiography or contrast-enhanced computer tomography. BD patients with CAD and age- and gender-matched BD patients without CAD (at 1:3 ratio) were enrolled. Demographic, clinical and laboratory data were systemically collected, analyzed and compared between two groups.
Results In total, 19 patients, including 17 male and 2 female, were complicated with CAD. The mean onset age of BD was 34 and the mean duration from the onset of BD to the diagnosis of CAD was 4.1 year. Angina pectoris (8/19) and acute myocardial infarction (8/19) were the most common cardiac symptoms, arrhythmia was presented in one patient, and three patient remained asymptomatic. Coronary artery aneurysm, stenosis and occlusion were presented in 9, 13 and 3 patients, respectively. Smoking (7/19) was frequently observed, while hypertension (3/16), diabetes mellitus (2/19), obesity (1/19) and alcohol consumption (1/19) were rarely present. Additionally, seven arterial and two venous extra-cardiac vasculopathies were presented. Oral ulceration (19/19) and skin lesions (16/19) were the most common BD-associated symptoms. Comparing with BD patients without CAD, patients with BD presented with higher ESR (mean, 34.4 vs 16.3 mm/hr, p=0.0018) and CRP (mean, 36.4 vs 12.2 mg/L, p=0.002), more frequency of skin lesions (84% vs 55%, p=0.0334) and pathergy reactions (37% vs 26%, p=0.0103). Furthermore, multivariate analysis confirmed that elevated CRP was a independent risk factor of CAD (OR 1.032, 95% CI 1.011–1.053, p=0.003).
Conclusions CAD, a rare complication of BD, predominately affect male patients. BD patients with CAD presented with active BD disease symptoms and elevated inflammatory markers, which implicated aberrant vascular inflammation was the key mechanism of CAD in BD patients. CRP, but not traditional CAD risk factors, was the risk factor of CAD in BD patients.
Disclosure of Interest None declared