Increased Cardiovascular Risk Factor Prevalence in Takayasu's Arteritis

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Better risk scores for predicting cardiovascular events in Takayasu's arteritis would be beneficial.
Better risk scores for predicting cardiovascular events in Takayasu's arteritis would be beneficial.

Patients with Takayasu's arteritis (TAK) have a higher frequency of cardiovascular risk factors, particularly hypertension, than patients without TAK, according to recent research.

The study, published online August 9 in Rheumatology, found that the Framington 10-year general cardiovascular (CV) risk score was higher in patients with TAK at the time of diagnosis compared with in those who did not have TAK who were of similar age and sex. The cumulative incidence of cardiovascular events (CVEs) in this study was also higher during follow-up.

In this retrospective study, the first cohort study to assess CV risk factors of patients with TAK in 2 different ethnic cohorts at the time of TAK diagnosis, the authors observed that CV risk factors are more common in patients with TAK, particularly hypertension.

"Our results suggest that patients with TAK should undergo careful assessment of CV risk factors, and an aggressive risk modification approach is warranted," the authors wrote. They noted that there is also a need for an aggressive risk modification approach.

TAK, a rare chronic large-vessel vasculitis, can lead to stenosis, occlusion, dilation, and aneurysm formation resulting from chronic vascular inflammation. The 10-year mortality rate for the disease ranges between 3% and 15%.

For this study, researchers followed 191 patients fulfilling the American College of Rheumatology criteria for TAK, and 191 non-TAK control patients at 2 referral rheumatology centers: 1 in Rochester, Minnesota, and 1 in Istanbul, Turkey. Control patients without TAK were matched by age, sex, and calendar year to patients with TAK. The 2008 Framingham 10-year general CV risk score was used for the determination of CV risk at the time of TAK incidence/index date. Researchers followed all subjects longitudinally through all available medical records until their last visit or date of death.

Results found that the prevalence of lipid-lowering treatment and hypertension were significantly more frequent in TAK. Occurrence of CVE was significantly higher in TAK before the incidence/index date. The Framington 10-year general CV risk score was also significantly higher in patients with TAK compared with non-TAK control patients at incidence/index date.

The risk for CVE was increased among patients with TAK (hazard ratio, 4.36; 95% CI, 1.25-15.13). The cumulative incidence of CVE was 15.4% at 10 years in TAK compared with 5.8% in non-TAK.

"Current CV risk assessment tools may not reflect the actual risk of CVE in TAK and better disease-specific risk scores for predicting CVE in large-vessel vasculitides are needed," they wrote.

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Reference

Alibaz-Oner F, Koster MJ, Unai AU, et al. Assessment of the frequency of cardiovascular risk factors in patients with Takayasu's arteritis [published online August 9, 2017]. Rheumatology. doi: 10.10931/rheumatology/kex300

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