Prognosis of large vessel involvement in large vessel vasculitis.,Journal of Autoimmunity

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Prognosis of large vessel involvement in large vessel vasculitis.
Journal of Autoimmunity ( IF 12.8 ) Pub Date : 2020-02-05 , DOI: 10.1016/j.jaut.2020.102419
Mathieu Vautier ₁ , Axelle Dupont ₂ , Hubert de Boysson ₃ , Chloé Comarmond ₁ , Tristan Mirault ₄ , Arsène Mekinian ₅ , Marc Lambert ₆ , Yasmina Ferfar ₁ , Achille Aouba ₃ , Patrice Cacoub ₁ , Matthieu Resche-Rigon ₂ , David Saadoun ₁

Affiliation

Department of Internal Medicine and Clinical Immunology, Centre de Référence des Maladies Auto-Immunes et Systémiques Rares, Centre de Référence des Maladies Auto- Inflammatoires, F-75013, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, And Inflammation- Immunopathology-Biotherapy Department (DHU I2B), F-75005, Paris, France; INSERM, UMR_S 959, F-75013, Paris, France; CNRS, FRE3632, F-75005, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtrière, France.
APHP Department of Biostatistics and Medical Information, Hôpital Saint-Louis; ECSTRA Team, CRESS UMR 1153, INSERM, Paris Diderot University, France.
Department of Internal Medecine, Caen University Hospital, University of Caen-Basse Normandie, France.
Centre de Référence des Maladies Vasculaires Rares, Hôpital Européen Georges-Pompidou, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France; INSERM U970 PARCC, Paris Descartes University, Sorbonne Paris Cité University, Paris, France.
Hôpital Saint-Antoine-APHP-Service de Médecine Interne, Paris, France.
Hôpital Claude Huriez, Service de Médecine Interne, Centre de Référence des Maladies Auto- Immunes et Systémiques Rares du Nord et Nord-Ouest (CeRAINAO), CHU, Université de Lille, Lille, France.

Objectives

To assess prognosis factors and outcome of large vessel involvement (LVI) in large vessels vasculitis (LVV) patients.

Methods

Retrospective multicenter study of characteristics and outcomes of 417 patients with LVI including 299 Takayasu arteritis (TAK) and 118 Giant cell arteritis (GCA-LVI) were analyzed. Logistic regression analysis assessed prognosis factors in LVV patients. Outcome of LVI among TAK and GCA-LVI patients (ischemic complications, aneurysms complications, relapses and revascularization) were assessed.

Results

In multivariable analysis, stroke/transient ischemic attack [HR: 3.63 (1.46–9.04), p = 0.006] was independently associated with vascular complications in LVV. The 10-years aneurysm free survival was significantly lower [67% (48–93) vs 89% (84–95), p = 0.02] in GCA-LVI compare to TAK patients. The 5-years relapse free survival was significantly lower [47% (37–60) vs 69% (63–75), p < 0.001,] in GCA-LVI compare to TAK patients. The 10-years revascularization free survival was significantly lower [55% (48–64) vs 76% (59–99), p < 0.001] in TAK compare to GCA-LVI patients. After a median follow-up of 5 years, 16 (5.4%) TAK and 7 (5.9%) GCA-LVI patients died, mainly of aneurysm (26%) and ischemic complications (26%).

Conclusion

This large nationwide cohort of LVI provided prognosis factors of vascular complications in LVV patients. TAK and GCA-LVI have different long-term outcome in term of aneurysm development, relapse and revascularization.

中文翻译：

大血管参与大血管血管炎的预后。

目标

评估大血管血管炎（LVV）患者的大血管受累（LVI）的预后因素和结果。

方法

对417例LVI患者的特征和结局进行回顾性多中心研究，其中包括299例Takayasu动脉炎（TAK）和118例巨细胞性动脉炎（GCA-LVI）。Logistic回归分析评估了LVV患者的预后因素。评估了TAK和GCA-LVI患者的LVI结果（缺血性并发症，动脉瘤并发症，复发和血运重建）。

结果

在多变量分析中，卒中/短暂性脑缺血发作[HR：3.63（1.46-9.04），p = 0.006]与LVV的血管并发症独立相关。与TAK患者相比，GCA-LVI的10年无动脉瘤生存率显着降低[67％（48-93）比89％（84-95），p = 0.02]。与TAK患者相比，GCA-LVI的5年无复发生存率显着降低[47％（37-60）比69％（63-75），p <0.001，]。与GCA-LVI患者相比，TAK的10年无血运重建生存率显着降低[55％（48-64）比76％（59-99），p <0.001]。中位随访5年后，有16名（5.4％）TAK和7名（5.9％）GCA-LVI患者死亡，主要死于动脉瘤（26％）和缺血性并发症（26％）。