Ischemic stroke in giant-cell arteritis: French retrospective study. (May 2019)

• Record Type: Journal Article
• Authors: Pariente, Aaron; Guédon, Alexis; Alamowitch, Sonia; Thietart, Sara; Carrat, Fabrice; Delorme, Stephen; Capron, Jean; Cacciatore, Carlotta; Soussan, Michael; Dellal, Azeddine; Fain, Olivier; Mekinian, Arsene
• Is Part Of: Journal of autoimmunity. Volume 99(2019)
• Page Start: 48
• Page End: 51
• Publication Date: 2019-05
• Subjects: Stroke -- Giant cell arteritis -- Outcome -- Treatment; Autoimmunity -- Periodicals; Autoimmune diseases -- Periodicals; Autoantibodies -- Periodicals; Autoimmune Diseases -- Periodicals; Auto-immunité -- Périodiques; Maladies auto-immunes -- Périodiques; Electronic journals; 616.978005
• DOI: 10.1016/j.jaut.2019.01.009
• Languages: English
• ISSNs: 0896-8411

Abstract

Abstract: Acute cerebrovascular ischemic events are a rare and severe complication of giant cell arteritis (GCA). We aimed to determine the prevalence of GCA-related stroke, the overall survival and the relapse-free survival in patients with GCA. A multicentric retrospective analysis was performed on 129 patients with GCA diagnosed between September 2010 and October 2018 in two University Hospitals. Among 129 GCA patients, 18 (16%) presented an acute ischemic cerebrovascular event. Patients with stroke were older (83 [67–96] years versus 76 [58–96]; p = 0.014) and more frequently males (61% versus 30%; p = 0.014) than those without stroke. The frequency of anterior ischemic optic neuropathy was higher in patients with stroke (n = 6, 33%) than patients without stroke (n = 12, 11%)(p = 0.02). Overall survival was significantly decreased in GCA patients with stroke (4.4 months), comparatively to patients without stroke (221.7 months; log rank test = 0.006). The 3-years relapse-free survival was decreased in patients with stroke (8.42 versus78.0 months; log rank = 0.0001), as well as the time with sustained remission (78 versus 139 months; log rank test = 0.0004). This study shows the prevalence and risk factors of ischemic stroke in GCA. Highlights: The ischemic stroke in GCA patients was noted in 16% of patients, and can occur concomitantly to GCA diagnosis. GCA patients with ischemic stroke were older males, with more frequent anterior ischemic optic neuropathy and more patients with previous diabetes.