Weak Association Observed Between Systemic Vasculitis and Myocardial Infarction

Systemic vasculitis, including large-vessel vasculitis (LVV), antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, and polyarteritis nodosa (PAN), are not significantly associated with an increased risk for MI, according to study results presented at the American College of Rheumatology (ACR) Convergence 2022, held from November 10 to 14, in Philadelphia, Pennsylvania.

Many rheumatologic disorders, such as systemic lupus erythematosus and rheumatoid arthritis, increase the risk for MI.

In the current study, the researchers sought to evaluate the association between vasculitis and MI.

Patients with vasculitis aged older than 40 years who had been admitted to teaching hospitals were included in the study. Individuals with Takayasu arteritis and eosinophilic granulomatosis with polyangiitis (EGPA) who were older than 18 years were included. Data were collected from the National Inpatient Sample between 2016 and 2019, using the International Classification of Diseases, Tenth Revision (ICD-10) codes.

Researchers conducted inverse probability weighting, with vasculitis of interest as the treatment and MI as the outcome. Adjustments were made for age, sex, race, family history of MI, hypertension, hyperlipidemia, diabetes, nicotine use, and obesity.  

Results of the study showed that the prevalence of MI was higher among patients with PAN and Takayasu arteritis compared with control participants. However, the prevalence of MI was lower in EGPA, giant cell arteritis (GCA), microscopic polyangiitis (MPA), and GPA.

Researchers observed that PAN, Takayasu arteritis, EGPA, GCA, and MPA were not statistically significant for MI. In fact, GPA and MPA had a slightly statistically significant negative association with MI.

Study limitations included the retrospective design, reliance on ICD codes, and the potential for unmeasured confounding.

The study authors concluded that patients with LVV, ANCA-associated vasculitis, and PAN “should be managed similarly to the general population in terms of preventive cardiovascular disease.”