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.

背景：由于高aya动脉炎（TA）病程的广泛差异，预测结果具有挑战性。我们评估了TA患者血管并发症的长期预后和预后因素。

方法：对318例符合美国风湿病学会和Ishikawa标准的TA患者的特征和结局进行回顾性多中心研究。评估与无事件生存，无复发生存以及血管并发症发生率相关的因素。在多变量模型中确定了血管并发症的危险因素。

结果： TA诊断时的中位年龄为36 [25-47]岁，其中276例患者（86.8％）为女性。中位随访6.1年后，观察到复发率为43％，血管并发症为38％，死亡为5％。进行性临床病程为45％，颈动脉痛为10％，视网膜病变为4％。5年和10年无事件生存，无复发生存和无并发症生存率分别为48.2％（42.2; 54.9）和36.4％（30.3; 43.9），58.6％（52.7; 65.1）和47.7％（ 41.2; 55.1）和69.9％（64.3; 76.0）和53.7％（46.8; 61.7）。进行性疾病病程（P = 0.018）和Carotidynia（P = 0.036）与无事件生存率独立相关。男性（P = 0.048），C反应蛋白升高（P= 0.013）和Carotidynia（P = 0.003）与无复发生存相关。进行性疾病病程（P = 0.017），胸主动脉受累（P = 0.009）和视网膜病变（P = 0.002）与无并发症生存相关。

结论：这项全国性研究表明，从诊断开始，TA患者中有50％会复发并出现≤10年的血管并发症。我们确定了特定特征，这些特征确定了那些随后发生血管并发症的风险最高的特征。