Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 10 Center Drive, Building 10, Rm 216G, Bethesda, MD 20892, USA.
Radiology and Imaging Sciences, National Institutes of Health, 10 Center Drive Building 10, Bethesda, MD 20892, USA.
Semin Arthritis Rheum. 2019 Jun;48(6):1068-1073. doi: 10.1016/j.semarthrit.2018.09.001. Epub 2018 Sep 17.
Calcification of the coronary arteries, aorta, and branch vessels can occur in both large-vessel vasculitis (LVV) and atherosclerosis. The study objective was to determine the location and amount of vascular calcification in patients with LVV versus hyperlipidemia (HLD) and to identify risk factors associated with vascular calcification in LVV.
Patients with giant cell arteritis (GCA), Takayasu's arteritis (TAK), and HLD underwent non-contrast computed tomography of the aorta and branch vessels. Vascular calcification in 14 specific arterial territories (4 segments of the aorta, 9 branch arteries, and the coronary arteries) was quantified throughout the large arteries by a cumulative Agatston score. Multivariate linear regression analyses were used to identify associations between traditional and disease-specific risk factors and total Agatston score.
A total of 88 subjects, including GCA (n = 29); TAK (n = 22); and HLD (n = 37), participated. Prevalence of vascular calcification in the aorta and branch vessels significantly differed in the coronary arteries (HLD = 67%, GCA = 35%, TAK = 9%, p < 0.01). Total Agatston scores were higher in GCA (median 3260, range 25-18,138) versus HLD (460, 19-17,215) (p < 0.01) but did not significantly differ between GCA and TAK (1944, 52-47,520) (p = 0.53). In multivariable regression analysis, age, type of vasculitis, and prednisone use was associated with vascular calcification in LVV.
The prevalence of coronary artery calcification is lower in LVV compared to HLD, but the amount of total vascular calcification throughout the large arteries is greater in LVV. Both traditional and disease-specific risk factors are associated with vascular calcification in LVV.
冠状动脉、主动脉和分支血管的钙化可发生于大血管血管炎（LVV）和动脉粥样硬化。本研究的目的是确定 LVV 患者与高脂血症（HLD）患者的血管钙化部位和程度，并确定与 LVV 血管钙化相关的危险因素。
巨细胞动脉炎（GCA）、Takayasu 动脉炎（TAK）和 HLD 患者进行了主动脉和分支血管的非对比计算机断层扫描。通过累积 Agatston 评分，在整个大动脉的 14 个特定动脉区域（主动脉的 4 个节段、9 个分支动脉和冠状动脉）量化血管钙化。采用多元线性回归分析，确定传统和疾病特异性危险因素与总 Agatston 评分之间的相关性。
共有 88 名受试者参与了研究，包括 GCA（n=29）、TAK（n=22）和 HLD（n=37）。主动脉和分支血管的血管钙化在冠状动脉的发生率明显不同（HLD=67%，GCA=35%，TAK=9%，p<0.01）。GCA 的总 Agatston 评分明显高于 HLD（中位数 3260，范围 25-18138）（p<0.01），但与 GCA 和 TAK 之间无显著差异（1944，52-47520）（p=0.53）。多元回归分析显示，年龄、血管炎类型和泼尼松的使用与 LVV 患者的血管钙化有关。
与 HLD 相比，LVV 患者的冠状动脉钙化发生率较低，但整个大动脉的总血管钙化量在 LVV 中较大。传统和疾病特异性危险因素与 LVV 血管钙化有关。
