Derivation of an angiographically based classification system in Takayasu's arteritis: an observational study from India and North America.

Autor:	Goel R; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India., Gribbons KB; Systemic Autoimmunity Branch, NIAMS, National Institutes of Health, Bethesda, MD, USA., Carette S; Division of Rheumatology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada., Cuthbertson D; Department of Biostatistics, University of South Florida, Tampa, FL., Hoffman GS; Department of Rheumatic and Immunologic Diseases, Cleveland Clinic Foundation, Cleveland, OH, USA., Joseph G; Department of Cardiology, Christian Medical College, Vellore, India., Khalidi NA; Division of Rheumatology, McMaster University, Hamilton, ON, Canada., Koening CL; Division of Rheumatology, University of Utah, Salt Lake City, UT., Kumar S; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India., Langford C; Department of Rheumatic and Immunologic Diseases, Cleveland Clinic Foundation, Cleveland, OH, USA., Maksimowicz-McKinnon K; Division of Rheumatology, Henry Ford Health System, Detroit, MI., McAlear CA; Division of Rheumatology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA., Monach PA; Division of Rheumatology, VA Boston Healthcare System, Boston, MA., Moreland LW; Division of Rheumatology, University of Pittsburgh, Pittsburgh, PA., Nair A; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India., Pagnoux C; Department of Biostatistics, University of South Florida, Tampa, FL., Quinn KA; Systemic Autoimmunity Branch, NIAMS, National Institutes of Health, Bethesda, MD, USA.; Division of Rheumatology, Georgetown University, Washington DC, USA., Ravindran R; Division of Rheumatology, Hiranandani Hospitals, Mumbai, India., Seo P; Division of Rheumatology, Johns Hopkins University, Baltimore, MD., Sreih AG; Division of Rheumatology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA., Warrington KJ; Division of Rheumatology, Mayo Clinic, Rochester, MN, USA., Ytterberg SR; Division of Rheumatology, Mayo Clinic, Rochester, MN, USA., Merkel PA; Division of Rheumatology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA., Danda D; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India., Grayson PC; Systemic Autoimmunity Branch, NIAMS, National Institutes of Health, Bethesda, MD, USA.
Jazyk:	angličtina
Zdroj:	Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2020 May 01; Vol. 59 (5), pp. 1118-1127.
DOI:	10.1093/rheumatology/kez421
Abstrakt:	Objectives: To develop and replicate, using data-driven methods, a novel classification system in Takayasu's arteritis based on distribution of arterial lesions. Methods: Patients were included from four international cohorts at major academic centres: India (Christian Medical College Vellore); North America (National Institutes of Health, Vasculitis Clinical Research Consortium and Cleveland Clinic Foundation). All patients underwent whole-body angiography of the aorta and branch vessels, with categorization of arterial damage (stenosis, occlusion or aneurysm) in 13 territories. K-means cluster analysis was performed to identify subgroups of patients based on pattern of angiographic involvement. Cluster groups were identified in the Indian cohort and independently replicated in the North American cohorts. Results: A total of 806 patients with Takayasu's arteritis from India (n = 581) and North America (n = 225) were included. Three distinct clusters defined by arterial damage were identified in the Indian cohort and replicated in each of the North American cohorts. Patients in cluster one had significantly more disease in the abdominal aorta, renal and mesenteric arteries (P < 0.01). Patients in cluster two had significantly more bilateral disease in the carotid and subclavian arteries (P < 0.01). Compared with clusters one and two, patients in cluster three had asymmetric disease with fewer involved territories (P < 0.01). Demographics, clinical symptoms and clinical outcomes differed by cluster. Conclusion: This large study in Takayasu's arteritis identified and replicated three novel subsets of patients based on patterns of arterial damage. Angiographic-based disease classification requires validation by demonstrating potential aetiological or prognostic implications. (Published by Oxford University Press on behalf of the British Society for Rheumatology 2019. This work is written by US Government employees and is in the public domain in the US.)
Databáze:	MEDLINE
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