University of Pavia, Department of Rheumatology, IRCCS Policlinico S. Matteo Fondazione, Pavia; University of Pavia, PhD in Experimental Medicine, Pavia, Italy; and NDORMS, Rheumatology Department, Nuffield Orthopaedic Centre, University of Oxford, UK.
Faculty of Health and Applied Sciences, University of the West of England; School of Clinical Sciences at South Bristol, University of Bristol, UK.
Clin Exp Rheumatol. 2020 Mar-Apr;38 Suppl 124(2):126-134. Epub 2019 Sep 6.
To analyse the frequency and predictors of new-onset cardiovascular (CV) risk factors in patients with anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV) and giant cell arteritis (GCA).
We analysed the frequency and predictors of new-onset hypertension and/or diabetes mellitus (HTN/DM) amongst patients with AAV or GCA recruited in the Diagnostic and Classification of Vasculitis (DCVAS) study. Patients with pre-existing HTN/DM were excluded.
We included 873 patients with AAV (506 GPA, 183 MPA, 184 EGPA), and 443 with GCA. Patients with GCA were more likely female (68% vs. 52%; p<0.001) and older (71.33±8.65 vs. 52.80±16.48; p<0.001) compared to patients with AAV. HTN/DM developed within 6 months of diagnosis in 9% of patients with AAV (6% in GPA, 21% in MPA, 3% in EGPA) and 6% of patients with GCA, p=0.15. Rise in creatinine/reduced glomerular filtration rate and/or anaemia (OR 3.98, 95% CI 2.09-7.59, p<0.001) and diagnosis (MPA: OR 2.42, 95%CI 1.52-3.83, p<0.001 and GCA: OR 2.12, 95%CI 1.34-3.38, p=0.001 vs. GPA) were significantly associated with the occurrence of HTN/DM after adjusting for age, sex, ethnicity, and smoking status. We developed and validated a predictive score to discriminate patients according to the risk of developing HTN/DM within 6 months from diagnosis.
Despite different epidemiological and clinical characteristics, new CV risk factors occur equally in the early stages of AAV and GCA. Renal function and type of diagnosis are associated with the occurrence of HTN/DM. We developed a simple predictive score for the risk-stratification of patients.
分析抗中性粒细胞胞浆抗体（ANCA）相关性血管炎（AAV）和巨细胞动脉炎（GCA）患者新发生心血管（CV）危险因素的频率和预测因素。
我们分析了在诊断和血管炎分类（DCVAS）研究中招募的 AAV 或 GCA 患者中新发生高血压和/或糖尿病（HTN/DM）的频率和预测因素。排除了有预存 HTN/DM 的患者。
我们纳入了 873 例 AAV 患者（506 例 GPA、183 例 MPA、184 例 EGPA）和 443 例 GCA 患者。GCA 患者更可能为女性（68%比 52%；p<0.001）和年龄更大（71.33±8.65 比 52.80±16.48；p<0.001）。AAV 患者中有 9%（GPA 为 6%、MPA 为 21%、EGPA 为 3%）和 GCA 患者中有 6%在诊断后 6 个月内发生 HTN/DM，p=0.15。肌酐升高/肾小球滤过率降低和/或贫血（OR 3.98，95%CI 2.09-7.59，p<0.001）和诊断（MPA：OR 2.42，95%CI 1.52-3.83，p<0.001 和 GCA：OR 2.12，95%CI 1.34-3.38，p=0.001 比 GPA）在调整年龄、性别、种族和吸烟状况后与 HTN/DM 的发生显著相关。我们开发并验证了一个预测评分，以根据诊断后 6 个月内发生 HTN/DM 的风险对患者进行区分。
尽管流行病学和临床特征不同，但 AAV 和 GCA 的早期阶段同样会出现新的 CV 危险因素。肾功能和诊断类型与 HTN/DM 的发生有关。我们开发了一个简单的预测评分来对患者进行风险分层。
