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Predictors of Cardiovascular Events in Patients With Takayasu Arteritis.

作者信息

He Shiping, Rong Zhan, Wang Yanhong, Wu Zhenbiao, Li Hongbin, Pan Lili, Duan Xinwang, Wu Lijun, Zhang Hongfeng, Yang Yunjiao, Li Jing, Zeng Xiaofeng

机构信息

Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, Beijing, China; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, China; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.

Department of Internal Medicine, Stony Brook University Hospital, New York, New York, USA.

出版信息

Can J Cardiol. 2025 Jul;41(7):1330-1338. doi: 10.1016/j.cjca.2025.03.022. Epub 2025 Mar 27.

DOI:10.1016/j.cjca.2025.03.022
PMID:40157642
Abstract

BACKGROUND

This study aimed to analyze the factors associated with cardiovascular events and develop a prediction model to predict 10-year cardiovascular events probability in patients with Takayasu arteritis (TAK).

METHODS

Patients with TAK were prospectively enrolled from 7 clinical centres between July 2013 and March 2021. The Cox proportional hazard regression was used to assess factors associated with cardiovascular events and develop a prediction model. The model performance was measured by Harrell's concordance index (C-index), Brier score, and calibration plots. The nomogram was used to calculate the 10-year cardiovascular events probability.

RESULTS

A total of 702 patients (aged 29.2 ± 9.9 years; 623 [88.7%] women) were included. Cardiovascular events were observed in 94 patients (13.4%) after a median follow-up of 67 months (interquartile range [IQR]: 46-99). Elevated erythrocyte sedimentation rate (ESR) at disease onset (hazard ratio [HR], 2.30 [1.47-3.60]), pulmonary hypertension (HR, 1.87 [0.93-3.77]), pulselessness (HR, 1.73 [1.14-2.63]), diagnostic delay ≥ 3 years (HR, 1.63 [1.01-2.65]), aortic regurgitation (HR, 1.61 [1.01-2.56]), and age at diagnosis (HR, 1.05 [1.02-1.07]) independently increased cardiovascular events and were included in the final model. The optimism-corrected C-index and Brier score of prediction model were 0.71 (0.66-0.76) and 0.072, respectively, and the calibration plots suggested good agreement between the observed and predicted probability of cardiovascular events.

CONCLUSIONS

Patients with TAK were at high risk of cardiovascular events. Advanced age at diagnosis, diagnosis delayed over 3 years, pulselessness, pulmonary hypertension, aortic regurgitation, and elevated ESR at disease onset were risk factors for cardiovascular events.

CLINICAL TRIAL REGISTRATION

JS-2038.

摘要

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