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Increased ischemic stroke, acute coronary artery disease and mortality in patients with granulomatosis with polyangiitis and microscopic polyangiitis
- Source :
- Journal of Autoimmunity, Journal of Autoimmunity, Elsevier, 2019, 96, pp.134-141. ⟨10.1016/j.jaut.2018.09.004⟩
- Publication Year :
- 2018
-
Abstract
- International audience; Objective: The aim of our study was to assess major cardiovascular event incidence, predictors, and mortality in ANCA-associated vasculitis (AAV).Methods: We conducted a retrospective cohort study of all GPA or MPA, according to Chapel Hill Consensus Conference classification criteria, diagnosed between 1981 and 2015. Major cardiovascular event was defined as acute coronary artery disease, or ischemic stroke, or peripheral vascular disease requiring a revascularization procedure. We calculated the comparative morbidity/mortality figure (CMF) and we used Cox proportional hazards regression models to assess the risk of coronary artery disease, ischemic stroke associated with AAV, after adjusting for covariates.Results: 125 patients, 99 GPA (79,2%) and 26 MPA (20,8%), were followed 88.4 ± 78.3 months. Ischemic stroke incidence was four times higher than in the general population (CMF 4,65; 95% CI 4,06-5,31). Coronary artery disease incidence was four times higher than in the general population (CMF 4,22; 95% CI 1,52-11,68). Smoking habits and history of coronary artery disease were strongly associated with coronary artery disease occurrence (adjusted HR 8.8; 95% CI 2.12-36.56, and adjusted HR 10.3; 95% CI 1.02-104.5, respectively). ENT flare-up was an independent protective factor for coronary artery disease occurrence. We did not identify factors significantly associated with stroke occurrence. The age-adjusted mortality rate was 22.5 per 1000 person-years. Mortality in AAV was 1.5 times higher than in the general population (CMF 1.56; 95% CI 1.34-1.83).Conclusion: AAV have a significantly increased risk of mortality, ischemic stroke, and coronary artery disease.
- Subjects :
- 0301 basic medicine
Male
Risk
medicine.medical_specialty
Immunology
Population
Microscopic Polyangiitis
Coronary Artery Disease
Antibodies, Antineutrophil Cytoplasmic
Coronary artery disease
Cohort Studies
03 medical and health sciences
0302 clinical medicine
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Ischemia
Internal medicine
Immunology and Allergy
Medicine
Humans
education
Stroke
Aged
Proportional Hazards Models
Retrospective Studies
030203 arthritis & rheumatology
education.field_of_study
Ischemic stroke
business.industry
Vascular disease
Incidence (epidemiology)
Mortality rate
Granulomatosis with Polyangiitis
Retrospective cohort study
Middle Aged
medicine.disease
Survival Analysis
3. Good health
030104 developmental biology
Acute Disease
Cardiology
Female
business
Granulomatosis with polyangiitis
ANCA-Associated vasculitis
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Follow-Up Studies
Subjects
Details
- ISSN :
- 10959157 and 08968411
- Volume :
- 96
- Database :
- OpenAIRE
- Journal :
- Journal of autoimmunity
- Accession number :
- edsair.doi.dedup.....0db2a9fe0b8c0e76164f9c08d2e77624