Arias Magela, Heydari-Kamjani Milad, Kesselman Marc M
Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, USA.
Rheumatology, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, USA.
Cureus. 2021 Feb 17;13(2):e13391. doi: 10.7759/cureus.13391.
Giant cell arteritis (GCA) is a large vessel vasculitis with a pathogenesis that involves two CD4 T-helper cell lineages, Th1 and Th17. The goal of GCA treatment is to achieve clinical remission and prevent complications, especially vision loss. Despite recent advances in treatment and diagnostic modalities for GCA, there continues to be a gap in the medical literature in addressing treatment and follow-up for patients with GCA after clinical remission is achieved. Of the most important issues to address in this patient population by rheumatologists and primary care physicians alike, is that of cardiovascular disease (CVD) risks in GCA patients associated with the vasculitis and its mainstay of treatment with high-dose glucocorticoids over a prolonged period of time. Physicians must be aware of the CVD events that have been observed in a higher proportion compared to the general population in GCA patients, including strokes, thoracic aortic aneurysms and dissections, myocardial infarctions, and peripheral vascular disease. This review will focus on the risk of CVD in GCA patients, with recommendations for management and follow-up.
巨细胞动脉炎（GCA）是一种大血管血管炎，其发病机制涉及两种CD4辅助性T细胞谱系，即Th1和Th17。GCA治疗的目标是实现临床缓解并预防并发症，尤其是视力丧失。尽管GCA的治疗和诊断方式最近取得了进展，但医学文献在临床缓解后对GCA患者的治疗和随访方面仍存在差距。风湿病学家和初级保健医生在该患者群体中需要解决的最重要问题之一，是GCA患者中与血管炎及其长期大剂量糖皮质激素治疗相关的心血管疾病（CVD）风险。医生必须意识到，与普通人群相比，GCA患者中观察到的CVD事件比例更高，包括中风、胸主动脉瘤和夹层、心肌梗死以及外周血管疾病。本综述将重点关注GCA患者的CVD风险，并提出管理和随访建议。
