Department of Rheumatology and Immunology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Clin Exp Rheumatol. 2024 Apr;42(4):843-851. doi: 10.55563/clinexprheumatol/ypq2lj. Epub 2024 Apr 11.
Coronary artery calcification (CAC) is frequently observed in Takayasu's arteritis (TAK). Our objective is to calculate the prevalence and severity of CAC in TAK, while evaluating the influence of traditional cardiovascular risk factors, glucocorticoid exposure, and disease activity on CAC.
This retrospective study involved 155 TAK patients. We measured the Agatston score by coronary computed tomography angiography (CCTA) and categorised all patients into groups with or without CAC (41 vs. 114) to compare clinical characteristics and ancillary findings between the two groups.
Among the TAK patients, a total of 41 TAK patients (26.45%) exhibited CAC. Age of onset, disease duration, history of hypertension, history of hyperlipidaemia, Numano V and glucocorticoid use emerged as the independent risk factors for developing CAC in TAK (OR [95% CI] 1.084[1.028-1.142], p=0.003; 1.005 [1.001-1.010], p=0.020; 4.792 [1.713-13.411], p=0.003; 4.199 [1.087-16.219], p=0.037; 3.287 [1.070-10.100], p=0.038; 3.558[1.269-9.977], p=0.016). Nonetheless, CAC was not associated with disease activity. Moreover, the extent of calcification score in TAK showed a positive correlation with the number of traditional cardiovascular risk factors.
We recommend CCTA screening for Numano V classified TAK patients. Glucocorticoid usage significantly escalates the risk of CAC. Therefore, in cases of effectively controlled disease, the inclusion of immunosuppressants aimed at reducing glucocorticoid dosage is advisable.
冠状动脉钙化（CAC）在大动脉炎（TAK）中经常观察到。我们的目的是计算 TAK 中 CAC 的患病率和严重程度，同时评估传统心血管危险因素、糖皮质激素暴露和疾病活动对 CAC 的影响。
这是一项回顾性研究，共纳入 155 例 TAK 患者。我们通过冠状动脉计算机断层血管造影（CCTA）测量 Agatston 评分，并将所有患者分为 CAC 组（41 例）和非 CAC 组（114 例），比较两组间的临床特征和辅助检查结果。
在 TAK 患者中，共有 41 例（26.45%）出现 CAC。发病年龄、病程、高血压史、高脂血症史、Numano V 分类和糖皮质激素使用是 TAK 患者发生 CAC 的独立危险因素（OR[95%CI]1.084[1.028-1.142]，p=0.003；1.005[1.001-1.010]，p=0.020；4.792[1.713-13.411]，p=0.003；4.199[1.087-16.219]，p=0.037；3.287[1.070-10.100]，p=0.038；3.558[1.269-9.977]，p=0.016）。然而，CAC 与疾病活动度无关。此外，TAK 患者的钙化评分程度与传统心血管危险因素的数量呈正相关。
我们建议对 Numano V 分类的 TAK 患者进行 CCTA 筛查。糖皮质激素的使用显著增加了 CAC 的风险。因此，在疾病得到有效控制的情况下，建议使用免疫抑制剂来减少糖皮质激素的剂量。
