Full Papers
Impact of coronary involvement on long-term outcomes in patients with Takayasu's arteritis
H. Wang1, Z. Liu2, Z. Shen3, L. Fang4, S. Zhang5
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China. pumch_lzy@163.com
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
- 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
Full Papers
Free to view
(click on article PDF icon to read the article)
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.