Background Persistent inflammation and immunosupressive treatment predispose patients (pts) with rheumatic diseases to early atherosclerosis. The risk of cardiovascular (CV) events in GPA is not well studied.
Objectives To evaluate the prevalence of CV risk factors, subclinical carotid atherosclerosis and CV outcomes in pts with GPA.
Methods 94 pts with GPA were enrolled (53 females, 41 males; mean age 54.0±14.9) in the stude. Diagnosis was established according to ACR criteria and CHCC2012. Mean value of Vasculitis Damage Index (VDI) was 1,8±1,9; VDI was <5 in 59 pts (mean age 51±14,8, 26 males, 33 females) and ≥5 (mean age 55±13,9, 15 males, 20 females) in 31 pts. Mean duration of GPA was 7±6,4 years. It was <5 лет in 47 pts (mean age 51±13,7, 24 males, 23 females) and ≥5 лет in 47 pts (mean age 55±14,7, 18 males, 29 females). Localized, early systemic and generalized disease was established in 29, 24 and 41 pts, respectively. ANCA, mainly to PR3, were positive in 69 pts. We studied the traditional CV risk factors and outcomes (stroke, myocardial infarction [MI], revascularization procedures). Subclinical atherosclerosis was evaluated using carotid US (TIM and plaques).
Results We revealed high prevalence of CV risk factors in GPA: dyslipidemia – 68%, hypertension – 74%, overweight – 63%. Carotid US showed increased TIM and plaques in 63% and 27%, respectively. 10 pts (11%) had history of CV events: MI (n=4), stroke (n=3) and revascularization procedures (n=3).
Prevalence of CV risk factors and subclinical atherosclerosis was similar in patients with VDI <5 и ≥5; the incidence of CV events was higher in patients with VDI ≥5 (20% vs 5%, р<0,05). The influence of GPA duration on prevalence of traditional risk factors, subclinical atherosclerosis and CV events was not established.
The prevalence of CV risk factors, subclinical atherosclerosis, CV events was similar in pts with local, early systemic and generalized GPA. The prevalence of CV risk factors and subclinical atherosclerosis was similar in ANCA(+) and ANCA(–) pts. The rate of CV events was insignificantly higher in ANCA(+) pts (p=0.19)
Conclusions The pts with GPA have high prevalence of CV risk factors, subclinical carotid atherosclerosis and increased risk of CV events. Severity of disease contributes to increased risk of CV events while duration of GPA has no effect.
Disclosure of Interest None Declared
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