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Impact of coronary involvement on long-term outcomes in patients with Takayasu's arteritis


1, 2, 3, 4, 5

 

  1. Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
  2. Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China. pumch_lzy@163.com
  3. Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
  4. Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
  5. Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.

CER12862
2020 Vol.38, N°6
PI 1118, PF 1126
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PMID: 32083549 [PubMed]

Received: 14/10/2019
Accepted : 30/12/2019
In Press: 14/02/2020
Published: 03/12/2020

Abstract

OBJECTIVES:
To identify the predictors of coronary involvement, and to determine the impact of coronary involvement on long-term outcomes in patients with Takayasu’s arteritis (TAK).
METHODS:
This retrospective cohort study of TAK patients with coronary evaluation by angiography or computed tomography angiography was conducted in a tertiary center between 1990 and 2018. Risk factors for coronary involvement and predictors of overall survival, cardiovascular event-free survival, and relapse-free survival were investigated.
RESULTS:
The median follow-up was 4.3 years (IQR 2.8–7.1). Out of 130 consecutive TAK patients, 71 (54.6%) had coronary involvement. Multivariate analysis revealed that age (OR: 1.537 per 10-year increase, 95% CI: 1.176–2.009, p=0.002) and type V angiographic classification (OR: 3.449, 95% CI: 1.600–7.437, p=0.002) were independent predictors of coronary involvement. Coronary involvement (HR: 8.358, 95% CI: 1.887–37.033, p=0.015), left ventricular systolic dysfunction (HR: 3.889, 95% CI: 1.467–10.311, p=0.006), and aortic regurgitation (HR: 3.373, 95% CI: 1.209–9.408, p=0.020) were independent predictors of overall survival. Furthermore, coronary involvement and baseline active disease were independently associated with increased major cardiovascular events (HR: 10.333, 95% CI: 2.326–45.906, p=0.017; HR: 7.084, 95% CI: 1.677–29.914, p=0.008, respectively) and relapse (HR: 5.186, 95% CI: 2.381–11.295, p<0.001; HR: 5.694, 95% CI: 2.022–16.031, p=0.001, respectively). No immunosuppressive therapy was independently associated with increased cardiovascular events (HR: 2.560, 95% CI: 1.181–5.550, p=0.002).
CONCLUSIONS:
Coronary involvement is an important predictor of poor long-term outcomes in patients with TAK. Increasing age and type V angiographic classification can help to identify TAK patients with coronary involvement.

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