POS0821 CORONARY ARTERIAL INVOLVEMENT CAN BE OBSERVED IN A SIGNIFICANT SUBSET OF TAKAYASU’S ARTERITIS PATIENTS BY CORONARY CT-ANGIOGRAPHY

Autor: K. Abacar, A. Cincin, F. Baltacioglu, Z. Dogan, G. Sevik, H. Direskeneli, F. Alibaz-Oner
Rok vydání: 2022
Předmět:
Zdroj: Annals of the Rheumatic Diseases. 81:701.2-701
ISSN: 1468-2060
0003-4967
Popis: BackgroundBesides the aorta and its main branches, coronary arterial involvement is also seen at a substantial rate in patients with Takayasu’s arteritis (TAK). Computerized tomography (CT)-angiography, as a non-invasive assessment tool, has started to be used instead of conventional angiography in the evaluation of coronary arteries. However limited data is available for its role in TAK patients.ObjectivesIn this study, we aimed to assess the coronary arterial involvement by coronary CT-angiography in TAK patients with or without symptoms and to compare clinical characteristics of patients with or without coronary arterial involvement.MethodsPatients with TAK (n=49, F/M: 40/9, mean age: 42.61±9.95 years) followed in Marmara University Vasculitis Clinic and underwent coronary CT-angiography with or without cardiac symptoms were evaluated retrospectively. Data of four patients who were not suitable for coronary CT-angiography but underwent conventional angiography were also included. CT angiography findings in the coronary arteries were defined as osteal stenosis, stenosis, calcific plaque and aneurysm and patients were categorized into two groups as those with or without coronary artery pathology. Demographic data, cardiac symptoms, clinical findings, BMIs, angiographic Hata and Goel classifications, treatments received for TAK, acute phase reactants and lipid levels were compared.ResultsCoronary artery pathology was detected in 14 patients (28.7%). Only 9 patients had a history of angina and 6 had cardiac symptoms in this group. Calcific plaque was present in 11 (22.5%), coronary artery stenosis in eight (16.3%) and aneurysm, osteal stenosis and occlusion in one patient each (2.0%). RCA was involved in 20.4%, LAD in 28.6%, LMCA in 22.4%, CX in 26.6% and more than one coronary arterial involvement in 26.5% of patients. In patients with coronary artery involvement, age (p=0.02), age at TAK diagnosis (p=0.004) and number of anti-hypertensive drugs (p=0.011) were significantly higher than those without coronary artery involvement. History of angina (p=0.004) and statin use (p=0.001) were also significantly higher in patients with coronary artery abnormalities, whereas HDL levels were significantly lower (p=0.037). No significant differences were observed between the groups when gender, smoking history, diabetes, BMI, ITAS2010 scores, biological therapy use, angiographic classifications, aortic involvement, presence of cardiac symptoms, CRP, ESR, total cholesterol and LDL levels were compared (Table 1).Table 1.Comparison of patient groups with and without coronary artery involvement (BMI: Body Mass Index, SD: Standard Deviation, ITAS: Indian Takayasu Activity Score, LDL: Low Density Lipoprotein, HDL: High Density Lipoprotein)Presence of Coronary Arterial Involvement (n=14)Absence of Coronary Arterial Involvement (n=35)p valueAge49.29 (8.23)39.94 (9.39)p=0.02Gender (F/M)10/430/5p=0.254Disease duration, years7.43 (6.42)8.46 (6.25)p=0.608Age at TAK diagnosis41.21 (12.58)31.37 (9.18)p=0.004Diabetes mellitus3/141/35p=0.065Family history4/147/35p=0.706Smoking history8/1425/35p=0.122BMI (kg/m2)25.08 (2.53)25.17 (4.68)p=0.930Biological therapy4/1415/34p=0.317CRP (mg/L) mean (SD)4.45 (3.4)8.68 (24.08)p=0.642ITAS2010 mean (SD)0.57 (0.94)0.51 (1.15)p=0.869LDL (mg/dL) mean (SD)102 (41.96)112.44 (35.79)p=0.398HDL (mg/dL) mean (SD)46.23 (12.78)55.12 (12.62)p=0.037Cardiac Symptom6/142/35p=0.159Aorta involvement8/1418/35p=0.717Statin use10/146/34p=0.001Number of antihypertensives1.79 (0.89)0.85 (1.18)p=0.011Acetylsalicylic acid use10/1424/34p=1Angina history9/146/35p=0.004ConclusionCoronary artery involvement which is an important cause of morbidity and mortality can be detected non-invasively by coronary CT-angiography in up to 1/3 of patients with Takayasu’s arteritis, also in patients without angina and cardiac symptoms. Traditional cardiac risk factors are present more commonly in this group.Disclosure of InterestsNone declared
Databáze: OpenAIRE
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