Age, anticoagulants, hypertension and cardiovascular genetic traits predict cranial ischaemic complications in patients with giant cell arteritis.

Autor:	Chaddock NJM; School of Medicine and Leeds Institute for Data Analytics, University of Leeds, Leeds, UK., Harden CJ; School of Medicine and Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.; NIHR Leeds Medicines and In Vitro Diagnostics Co-operative, Leeds Teaching Hospitals NHS Trust, Leeds, UK., Sorensen L; School of Medicine and Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK., Mathieson HR; School of Medicine and Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK., Zulcinski M; School of Medicine and Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK., Lawson CA; Harrogate District Hospital, Harrogate, UK., O'Sullivan E; Ophthalmology, King's College Hospital NHS, London, UK., Mollan SP; Ophthalmology, University Hospitals Birmingham, Birmingham, UK.; Neurometabolism, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK., Martin J; Institute of Parasitology and Biomedicine, López-Neyra, IPBLN, CSIC, Granada, Spain., Mackie SL; School of Medicine and Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK., Iles MM; School of Medicine and Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK., Morgan AW; School of Medicine and Leeds Institute for Data Analytics, University of Leeds, Leeds, UK a.w.morgan@leeds.ac.uk.; NIHR Leeds Medicines and In Vitro Diagnostics Co-operative, Leeds Teaching Hospitals NHS Trust, Leeds, UK.; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Jazyk:	angličtina
Zdroj:	Annals of the rheumatic diseases [Ann Rheum Dis] 2024 Oct 03. Date of Electronic Publication: 2024 Oct 03.
DOI:	10.1136/ard-2024-225515
Abstrakt:	Objectives: This project aimed to determine whether cranial ischaemic complications at the presentation of giant cell arteritis (GCA) were associated with pre-existing cardiovascular (CV) risk factors, CV disease or genetic risk of CV-related traits. Methods: 1946 GCA patients with clinicodemographic data at GCA presentation were included. Associations between pre-existing CV-related traits (including Polygenic Risk Scores (PRS) for CV traits) and cranial ischaemic complications were tested. A model for cranial ischaemic complications was optimised using an elastic net approach. Positional gene mapping of associated PRS was performed to improve biological understanding. Results: In a sample of 1946 GCA patients (median age=71, 68.7% female), 17% had cranial ischaemic complications at presentation. In univariable analyses, 10 variables were associated with complications (likelihood-ratio test p≤0.05). In multivariable analysis, the two variables with the strongest effects, with or without PRS in the model, were anticoagulant therapy (adjusted OR (95% CI)=0.21 (0.05 to 0.62), p=4.95×10 -3 ) and age (adjusted OR (95% CI)=1.60 (0.73 to 3.66), p=2.52×10 -3 , for ≥80 years versus <60 years). In sensitivity analyses omitting anticoagulant therapy from multivariable analysis, age and hypertension were associated with cranial ischaemic complications at presentation (hypertension: adjusted OR (95% CI)=1.35 (1.03 to 1.75), p=0.03). Positional gene mapping of an associated transient ischaemic attack PRS identified TEK , CD96 and MROH9 loci. Conclusion: Age and hypertension were risk factors for cranial ischaemic complications at GCA presentation, but in this dataset, anticoagulation appeared protective. Positional gene mapping suggested a role for immune and coagulation-related pathways in the pathogenesis of complications. Further studies are needed before implementation in clinical practice. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ on behalf of EULAR.)
Databáze:	MEDLINE
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