Risk Factors for Cardiovascular Events in Behçet Disease Assessed

Sex, smoking status, the presence of papulopustular lesions, and higher activated partial thromboplastin time (APTT) were found to be associated with cardiovascular (CV) involvement in patients with Behçet disease, according to findings from a retrospective study published in the Journal of Translational Autoimmunity.

Cardiovascular involvement among patients with Behçet disease typically presents as a systemic vasculitis that may include both arteries and veins of various sizes. Arterial occlusions, venous thrombotic occlusions, aneurysm formations, pseuodaneurysm formations, and stenoses may be observed in this patient population.

The researchers sought to evaluate the potential risk factors for CV involvement in individuals with Behçet disease.

The study was conducted at the First Affiliated Hospital of Zhejiang University School of Medicine, China. The researchers collected clinical data from all inpatients with suspected Behçet disease between January 2011 and December 2021. Patients with Behçet disease met the 1990 International Study Group criteria or the International Criteria for Behcet’s Disease criteria.

Clinical evaluations and imaging techniques for confirming CV involvement in patients with Behçet disease included transthoracic echocardiography, transesophageal echocardiography, computed tomography (CT) angiography, magnetic resonance imaging (MRI) angiography, and Doppler ultrasonography.

Participants were divided into 2 groups, including the Behçet disease-CV group (ie, patients with Behçet disease and CV involvement) and the non-CV Behçet disease group (ie, patients with Behçet disease without CV involvement; control group).

Of the 21 patients in the Behçet disease-CV group, 7 experienced arterial involvement, 8 venous involvement, 12 cardiac involvement, and 6 multiple vascular involvement.

Levels of APTT, cardiac troponin I, and C-reactive protein were all significantly higher in the  Behçet disease-CV group compared with the control group (P =.001, P =.031, and P =.034, respectively). All patients with Behçet disease had high median levels of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio, both of which may serve as potential indices to assess disease activity among patients with Behçet disease.

According to multivariate logistic regression analysis, papulopustular lesions (odds ratio [OR], 4.279; 95% CI, 1.243-14.729: P =.021), smoking (OR, 3.938; 95% CI, 1.152-13.469; P =.029), and high APTT levels (OR, 1.119; 95% CI, 1.033-1.213; P =.006) were significantly associated with CV involvement among patients with Behçet disease.

Receiver operating characteristic (ROC) curve analysis, which was used to assess the predictive value of CV involvement in patients with Behçet disease, revealed that the best cutoff value of APTT was 33.15 seconds (sensitivity, 57.1%; specificity, 82.2%; area under the curve [AUC], 0.7389; 95% CI, 0.6217-0.8561; P =.0007).

Study limitations included its small sample size, retrospective design, and potential selection bias.

“All patients newly diagnosed with [Behçet disease] should be systematically screened for cardiovascular involvement. Further studies are required to assess potential predictive factors associated with [CV] involvement in [Behçet disease],” the study authors concluded.