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Evaluation of clinical measurements and development of new diagnostic criteria for Takayasu arteritis in a Chinese population

X. Kong¹, L. Ma², L. Wu³, H. Chen⁴, L. Ma⁵, Y. Sun⁶, W. Wu⁷, Z. Ji⁸, Z. Zhang⁹, C. Yang¹⁰, S. Ye¹¹, S. Chen¹², S. Dai¹³, Y. Xue¹⁴, G. Qin¹⁵, Y. Zou¹⁶, Q. Yu¹⁷, L. Jiang¹⁸

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Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Rheumatology, People’s Hospital of Urumqi, Xinjiang, China.
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Rheumatology, Renji Hospital, Jiaotong University, Shanghai, China.
Department of Rheumatology, Renji Hospital, Jiaotong University, Shanghai, China.
Department of Rheumatology, Renji Hospital, Jiaotong University, Shanghai, China.
Department of Rheumatology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Department of Rheumatology, Huashan Hospital, Fudan University, Shanghai, China.
Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China.
Department of Rheumatology, People’s Hospital of Wuxi, Jiangsu, China.
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.

CER7803
2015 Vol.33, N°2 ,Suppl.89
PI 0048, PF 0055
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PMID: 25738632 [PubMed]

Received: 01/08/2014
Accepted : 09/12/2014
In Press: 18/02/2015
Published: 26/05/2015

Abstract

OBJECTIVES:
Takayasu arteritis (TA) is a chronic granulomatous large-vessel vasculitis. When diagnosing TA, the criteria designed by the American College of Rheumatology (ACR) are used commonly but they were just classification criteria. There is an urgent need for a new set of diagnostic criteria.
METHODS:
One hundred and thirty-one TA patients and 132 control patients with other types of vascular disease were enrolled and both groups were distributed into a “training set” and a “validation set”. All general information as well as clinical, laboratory and imaging data were collected. After comparing all the medical records of two groups in the training set, logistic regression and clinical judgment were used to form the new criteria for TA. The new criteria were tested by the validation set.
RESULTS:
New TA diagnostic criteria within total score 26 include age (<40 years), female, chest pain/chest distress, amaurosis, vascular bruits, a decreased/absent pulse, involvement of the aortic arch or its major branches, and involvement of the abdominal aorta or its branches. Patients with a score ≥8 were diagnosed as TA. The sensitivity and specificity of our new criteria were 91.92% and 93.94%, respectively, higher than those of the ACR criteria (75.76%, 85.86%) and the Ishikawa criteria (56.57%, 94.95%). The areas under the ROC curves of the new criteria and ACR criteria were 0.981 and 0.868, respectively (p<0.001). Sensitivity and specificity tested in the validation set were 90.63% and 96.97%, respectively.
CONCLUSIONS:
The new diagnostic criteria exhibited high sensitivity and specificity and have demonstrated to be feasible in the diagnosis of TA.