Background and objective: Systemic small vessel vasculitides carry an increased risk of acute arterial and venous thromboembolic events (AVTE); however, this risk has not been systematically explored in Eosinophilic Granulomatosis with Polyangiitis (EGPA). This study assessed the occurrence and main risk factors of AVTE among EGPA patients as compared to the general community from the population-based Bruneck cohort. Methods: We conducted a retrospective multicenter cohort study on 573 EGPA patients. Clinical and serological data were collected at diagnosis. Occurrence of AVTE and time to the first AVTE after EGPA diagnosis were recorded. Age-standardized event rate (SER) of AVTE as compared to the reference cohort was assessed. Cox regression was applied to identify AVTE predictors. Results: 129 EGPA patients (22.5%) had AVTE, considered as potentially life-threatening in 55.8%. Seventy patients experienced an AVTE prior to diagnosis (of whom 58.6% in the two years before diagnosis) and 75 following EGPA diagnosis, of whom 56% in the two subsequent years. The SER of AVTE as compared to the reference cohort was 2.10 (95% CI 1.67-2.63). This risk was particularly increased in patients with history of AVTE and with a Birmingham Vasculitis Activity Score ≥20 at diagnosis. Patients receiving immunosuppression within 2 months of diagnosis were at lower risk, while antiplatelet or anticoagulant treatment did not confer measurable benefit. Conclusion: EGPA is associated with AVTE in approximately one quarter of patients, particularly around diagnosis. Immunosuppressants seemed to exert a protective effect, while anticoagulant and antiplatelet agents did not.

中文翻译：

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嗜酸性肉芽肿合并多血管炎（Churg-Strauss综合征）的急性动脉和静脉血栓栓塞事件的风险

背景和目的：全身性小血管血管炎引起急性动脉和静脉血栓栓塞事件（AVTE）的风险增加；然而，在嗜酸性肉芽肿合并多血管炎（EGPA）中尚未系统地探讨这种风险。这项研究评估了以人群为基础的Bruneck队列与一般社区相比，EGPA患者中AVTE的发生率和主要危险因素。方法：我们对573名EGPA患者进行了回顾性多中心队列研究。诊断时收集临床和血清学数据。记录AVTE的发生情况和EGPA诊断后首次出现AVTE的时间。与参考队列相比，评估了AVTE的年龄标准化事件发生率（SER）。应用Cox回归来确定AVTE预测因子。结果：129名EGPA患者（22.5％）患有AVTE，被认为可能威胁生命的人占55.8％。70名患者在诊断前经历了AVTE（其中58.6％在诊断前的两年中）和75名在EGPA诊断后经历了AVTE，其中56％在随后的两年中。与参考队列相比，AVTE的SER为2.10（95％CI 1.67-2.63）。诊断为AVTE病史和伯明翰血管炎活动评分≥20的患者，这种危险尤其增加。在诊断后2个月内接受免疫抑制的患者风险较低，而抗血小板或抗凝治疗未带来可衡量的益处。结论：大约四分之一的患者，尤其是在诊断周围，EGPA与AVTE相关。免疫抑制剂似乎起保护作用，而抗凝剂和抗血小板药则没有。