Long-Term Outcomes and Prognostic Factors of Complications in Takayasu Arteritis: A Multicenter Study of 318 Patients. Issue 12 (19th September 2017)

• Record Type: Journal Article
• Authors: Comarmond, Cloé; Biard, Lucie; Lambert, Marc; Mekinian, Arsène; Ferfar, Yasmina; Kahn, Jean-Emmanuel; Benhamou, Ygal; Chiche, Laurent; Koskas, Fabien; Cluzel, Philippe; Hachulla, Eric; Messas, Emmanuel; Resche-Rigon, Matthieu; Cacoub, Patrice; Mirault, Tristan; Saadoun, David
• Is Part Of: Circulation. Volume 136:Issue 12(2017)
• Publication Date: 2017-09-19
• Subjects: outcome -- prognosis -- relapse -- Takayasu arteritis -- vasculitis; Blood -- Circulation -- Periodicals; Cardiovascular system -- Periodicals; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; Blood Circulation; Cardiovascular System; Vascular Diseases; 616.1
• DOI: 10.1161/CIRCULATIONAHA.116.027094
• Languages: English
• ISSNs: 0009-7322

Abstract

Abstract : Background: Because of the wide variation in the course of Takayasu arteritis (TA), predicting outcome is challenging. We assess long-term outcome and prognosis factors for vascular complications in patients with TA. Methods: A retrospective multicenter study of characteristics and outcomes of 318 patients with TA fulfilling American College of Rheumatology and Ishikawa criteria was analyzed. Factors associated with event-free survival, relapse-free survival, and incidences of vascular complications were assessed. Risk factors for vascular complications were identified in a multivariable model. Results: The median age at TA diagnosis was 36 [25–47] years, and 276 patients (86.8%) were women. After a median follow-up of 6.1 years, relapses were observed in 43%, vascular complications in 38%, and death in 5%. Progressive clinical course was observed in 45%, carotidodynia in 10%, and retinopathy in 4%. The 5- and 10-year event-free survival, relapse-free survival, and complication-free survival were 48.2% (42.2; 54.9) and 36.4% (30.3; 43.9), 58.6% (52.7; 65.1) and 47.7% (41.2; 55.1), and 69.9% (64.3; 76.0) and 53.7% (46.8; 61.7), respectively. Progressive disease course ( P =0.018) and carotidynia ( P =0.036) were independently associated with event-free survival. Male sex ( P =0.048), elevated C-reactive protein ( P =0.013), and carotidynia ( P =0.003) were associated with relapse-free survival. Progressive disease course ( P =0.017), thoracic aorta involvement ( P =0.009), and retinopathy ( P =0.002) were associated with complication-free survival. Conclusions: This nationwide study shows that 50% of patients with TA will relapse and experience a vascular complication ⩽10 years from diagnosis. We identified specific characteristics that identified those at highest risk for subsequent vascular complications.