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. 2021 Mar;73(3):504-511.
doi: 10.1002/art.41529. Epub 2021 Jan 22.

Cardiovascular and Renal Morbidity in Takayasu Arteritis: A Population-Based Retrospective Cohort Study From the United Kingdom

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Cardiovascular and Renal Morbidity in Takayasu Arteritis: A Population-Based Retrospective Cohort Study From the United Kingdom

Ruchika Goel et al. Arthritis Rheumatol. 2021 Mar.

Abstract

Objective: Cardiovascular disease (CVD) is a major complication and cause of mortality in Takayasu arteritis (TAK), but population-based controlled studies from the UK are lacking. We undertook the present study to investigate the frequency of morbidity and mortality related to CVD, as well as to cerebrovascular and kidney disease, among patients with TAK in the UK.

Methods: Yearly cohort and cross-sectional studies were performed from 2000 to 2017 to estimate annual incidence and prevalence, respectively, of TAK. Using a UK primary care database (IQVIA Medical Research Data), an open retrospective matched cohort study was conducted to estimate risk of hypertension, diabetes, cardiovascular morbidity, chronic kidney disease (CKD), and all-cause mortality in TAK. Risk (adjusted hazard ratio [HR]) of the assessed comorbidities among patients with TAK compared to age- and sex-matched controls was estimated. Changes in medication prescription over time were examined in both groups.

Results: One hundred forty-two patients with TAK (median age 53.4 years [interquartile range 33.8-70.7]) and 1,371 matched controls were included. The annual incidence and prevalence of TAK were 0.8 per million and 7.5 per million respectively. All-cause mortality was increased in TAK (adjusted HR 1.88 [95% confidence interval 1.29-2.76]). Patients with TAK had an increased risk of developing ischemic heart disease, stroke/transient ischemic attack, combined CVD, and peripheral vascular disease compared to controls, but no increase in risk of hypertension, CKD, heart failure, or diabetes. Only ~50% of patients with TAK requiring secondary CVD prevention were prescribed statins or antiplatelet agents within 1 year after study entry.

Conclusion: Cardiovascular morbidity was increased among patients with TAK receiving primary care services in the UK. Treatment with statins and antiplatelet agents in these patients was suboptimal.

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Comment in

  • Reply.
    Goel R, Chandan JS, Thayakaran R, Adderley NJ, Nirantharakumar K, Harper L. Goel R, et al. Arthritis Rheumatol. 2021 Oct;73(10):1948-1950. doi: 10.1002/art.41789. Epub 2021 Aug 18. Arthritis Rheumatol. 2021. PMID: 33982888 No abstract available.
  • Concerns Regarding the Analysis of a Takayasu Arteritis Cohort: Comment on the Article by Goel et al.
    Yazici H, Oztas M, Yazici Y. Yazici H, et al. Arthritis Rheumatol. 2021 Oct;73(10):1948. doi: 10.1002/art.41784. Epub 2021 Aug 18. Arthritis Rheumatol. 2021. PMID: 33982898 No abstract available.
  • Cardiovascular and Renal Morbidity in Takayasu Arteritis: Comment on the Article by Goel et al.
    Liu HH, Tsai HH, Wei JC. Liu HH, et al. Arthritis Rheumatol. 2021 Nov;73(11):2145. doi: 10.1002/art.41804. Epub 2021 Sep 22. Arthritis Rheumatol. 2021. PMID: 34042289 No abstract available.
  • Reply.
    Goel R, Chandan JS, Thayakaran R, Adderley NJ, Nirantharakumar K, Harper L. Goel R, et al. Arthritis Rheumatol. 2021 Nov;73(11):2145-2146. doi: 10.1002/art.41809. Epub 2021 Sep 22. Arthritis Rheumatol. 2021. PMID: 34042302 No abstract available.

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