Clinically Apparent Arterial Thrombosis in Persons with Systemic Vasculitis

Author:

Tsoukas Alexander1ORCID,Bernatsky Sasha12ORCID,Joseph Lawrence23,Buckeridge David L.345,Bélisle Patrick2,Pineau Christian A.1

Affiliation:

1. Division of Rheumatology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada

2. Division of Clinical Epidemiology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada

3. McGill Clinical and Health Informatics, McGill University, Montreal, QC, Canada

4. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada

5. Office of Surveillance and Epidemiology, Montreal Public Health Department, Montreal, QC, Canada

Abstract

Objective. To estimate the incidence rate of clinically apparent arterial thrombotic events and associated comorbidities in patients with primary systemic vasculitis. Methods. Using large cohort administrative data from Quebec, Canada, we identified patients with vasculitis, including polyarteritis nodosa (PAN) and granulomatosis with polyangiitis (GPA). Incident acute myocardial infarctions (AMIs) and cerebrovascular accidents (CVAs) after the diagnosis of vasculitis were ascertained in the PAN and GPA group via billing and hospitalization data. These were compared to rates of a general population comparator group. The incidences of comorbidities (type 2 diabetes mellitus, dyslipidemia, and hypertension) were also collected. Results. Among the 626 patients identified with vasculitis, 19.7% had PAN, 2.9% had Kawasaki disease, 23.8% had GPA, 52.4% had GCA, and 1.3% had Takayasu arteritis. The AMI rate was substantially higher in males aged 18–44 with PAN, with rates up to 268.1 events per 10,000 patient years [95% CI 67.1–1070.2], approximately 30 times that in the age- and sex-matched control group. The CVA rate was also substantially higher, particularly in adults aged 45–65. Patients with vasculitis had elevated incidences of diabetes, dyslipidemia, and hypertension versus the general population. Conclusion. Atherothrombotic rates were elevated in patients identified as having primary systemic vasculitis. While incident rates of cardiovascular comorbidities were also increased, the substantial elevation in AMIs seen in young adults suggests a disease-specific component which requires further investigation.

Funder

Canadian Institute for Health Research

Publisher

Hindawi Limited

Subject

Immunology,Rheumatology

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