Coronary Artery Disease in a Population-Based Cohort of Biopsy-Proven Giant Cell Arteritis in Southern Sweden
(2019) American College of Rheumatology, 2019 In Arthritis & Rheumatology 71(Suppl 10).- Abstract
- Background/Purpose: The aim of this study was to estimate the incidence rate and prevalence of coronary artery diseases (CAD) in patients with temporal artery positive giant cell arteritis (TAB+GCA) from a defined population in southern Sweden, and to describe characteristics of CAD in this sample.
Methods: The study cohort consisted of 1202 patients (71.9% women) diagnosed with TAB+GCA between 1997 and 2016. Patients were identified from the database of the Department of Pathology which covers all the hospitals in the Skåne region of Sweden. The cohort was linked to the registry for acute coronary care (SWEDEHEART) which provides nationwide coverage since 1995. All the GCA patients with symptoms suggesting acute coronary syndrome... (More) - Background/Purpose: The aim of this study was to estimate the incidence rate and prevalence of coronary artery diseases (CAD) in patients with temporal artery positive giant cell arteritis (TAB+GCA) from a defined population in southern Sweden, and to describe characteristics of CAD in this sample.
Methods: The study cohort consisted of 1202 patients (71.9% women) diagnosed with TAB+GCA between 1997 and 2016. Patients were identified from the database of the Department of Pathology which covers all the hospitals in the Skåne region of Sweden. The cohort was linked to the registry for acute coronary care (SWEDEHEART) which provides nationwide coverage since 1995. All the GCA patients with symptoms suggesting acute coronary syndrome who had been admitted to a coronary care unit (CCU) were identified. CAD was defined as an admission to a CCU for ST-Elevation Myocardial Infarction (STEMI), Non-ST-Elevation Myocardial Infarction (NSTEMI), stable angina, or unstable angina. For incidence rate analyses, the person-years of follow-up was calculated from GCA diagnosis until first CAD, death or December 31, 2016, whichever came first.
Results: 126 of 1202 GCA patients had suffered at least one acute coronary event (Table 1) yielding the cumulative incidence of 10.5% (95% CI 8.7-12.3). Of the 126 patients with CAD, 44 (34.9%) were diagnosed with CAD before their GCA diagnosis, 11 (8.7%) both before and after their diagnosis, and 71 (56.3%) solely after their GCA diagnosis. The total number of CCU admissions of all the 126 GCA CAD+ patients was 209: 101 admissions (48.3%) for NSTEMI, 55 (26.3%) for stable angina, 29 (13.9%) for STEMI, and 24 (11.5%) for unstable angina. Eighty-two GCA patients (61% women) developed CAD after their diagnosis of GCA. During a total follow-up time of 8047 person-years, the incidence rate of CAD in patients with TAB+GCA was 1.0 per 100 person-years (95% CI 0.8-1.2) for all patients, 0.8 (95% CI 0.6-1.1) for women and 1.6 (95% CI 1.1-2.2) for men, p=0.02. Fifteen GCA patients suffered from a CAD event in 1156 person-years during the first year after the GCA diagnosis, resulting in an incidence rate of 1.3 per 100 person-years (95% CI 0.6-2.0). 703/1202 (58.5%) GCA patients were alive on December 31, 2016, of which 72 patients had at least one previous CAD event yielding a prevalence of CAD in GCA of 10.2%.
Conclusion: The incidence of CAD in GCA is comparable to what has been previously found in the Swedish background population. The incidence rate is higher among men compared to women. Coronary artery disease affects every tenth patient with TAB+GCA in this cohort. Further studies are needed to explore the impact of CAD on clinical outcomes in patients with GCA. (Less)
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https://lup.lub.lu.se/record/e77555d8-4db7-4134-a7f2-2200d253daaa
- author
- Stamatis, Pavlos LU ; Mohammad, Moman LU ; Merkel, Peter A ; Englund, Martin LU ; Turesson, Carl LU ; Erlinge, David LU and Mohammad, Aladdin LU
- organization
-
- Rheumatology
- Molecular Cardiology (research group)
- Cardiology
- Lund OsteoArthritis Division - Clinical Epidemiology Unit (research group)
- Orthopaedics (Lund)
- EpiHealth: Epidemiology for Health
- Internal Medicine - Epidemiology (research group)
- Lund Vasculitis Epidemiology Research Group (research group)
- Autoimmunity and kidney diseases (research group)
- publishing date
- 2019
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Arthritis & Rheumatology
- volume
- 71
- issue
- Suppl 10
- article number
- 2692
- publisher
- John Wiley & Sons Inc.
- conference name
- American College of Rheumatology, 2019
- conference location
- Atlanta, United States
- conference dates
- 2019-11-08 - 2019-11-13
- external identifiers
-
- pmid:31661605
- scopus:85074300353
- ISSN
- 2326-5205
- DOI
- 10.1002/art.41108
- language
- English
- LU publication?
- yes
- id
- e77555d8-4db7-4134-a7f2-2200d253daaa
- date added to LUP
- 2020-05-31 07:52:44
- date last changed
- 2022-03-11 01:27:31
@misc{e77555d8-4db7-4134-a7f2-2200d253daaa, abstract = {{Background/Purpose: The aim of this study was to estimate the incidence rate and prevalence of coronary artery diseases (CAD) in patients with temporal artery positive giant cell arteritis (TAB+GCA) from a defined population in southern Sweden, and to describe characteristics of CAD in this sample.<br/><br/>Methods: The study cohort consisted of 1202 patients (71.9% women) diagnosed with TAB+GCA between 1997 and 2016. Patients were identified from the database of the Department of Pathology which covers all the hospitals in the Skåne region of Sweden. The cohort was linked to the registry for acute coronary care (SWEDEHEART) which provides nationwide coverage since 1995. All the GCA patients with symptoms suggesting acute coronary syndrome who had been admitted to a coronary care unit (CCU) were identified. CAD was defined as an admission to a CCU for ST-Elevation Myocardial Infarction (STEMI), Non-ST-Elevation Myocardial Infarction (NSTEMI), stable angina, or unstable angina. For incidence rate analyses, the person-years of follow-up was calculated from GCA diagnosis until first CAD, death or December 31, 2016, whichever came first.<br/><br/>Results: 126 of 1202 GCA patients had suffered at least one acute coronary event (Table 1) yielding the cumulative incidence of 10.5% (95% CI 8.7-12.3). Of the 126 patients with CAD, 44 (34.9%) were diagnosed with CAD before their GCA diagnosis, 11 (8.7%) both before and after their diagnosis, and 71 (56.3%) solely after their GCA diagnosis. The total number of CCU admissions of all the 126 GCA CAD+ patients was 209: 101 admissions (48.3%) for NSTEMI, 55 (26.3%) for stable angina, 29 (13.9%) for STEMI, and 24 (11.5%) for unstable angina. Eighty-two GCA patients (61% women) developed CAD after their diagnosis of GCA. During a total follow-up time of 8047 person-years, the incidence rate of CAD in patients with TAB+GCA was 1.0 per 100 person-years (95% CI 0.8-1.2) for all patients, 0.8 (95% CI 0.6-1.1) for women and 1.6 (95% CI 1.1-2.2) for men, p=0.02. Fifteen GCA patients suffered from a CAD event in 1156 person-years during the first year after the GCA diagnosis, resulting in an incidence rate of 1.3 per 100 person-years (95% CI 0.6-2.0). 703/1202 (58.5%) GCA patients were alive on December 31, 2016, of which 72 patients had at least one previous CAD event yielding a prevalence of CAD in GCA of 10.2%.<br/><br/>Conclusion: The incidence of CAD in GCA is comparable to what has been previously found in the Swedish background population. The incidence rate is higher among men compared to women. Coronary artery disease affects every tenth patient with TAB+GCA in this cohort. Further studies are needed to explore the impact of CAD on clinical outcomes in patients with GCA.}}, author = {{Stamatis, Pavlos and Mohammad, Moman and Merkel, Peter A and Englund, Martin and Turesson, Carl and Erlinge, David and Mohammad, Aladdin}}, issn = {{2326-5205}}, language = {{eng}}, note = {{Conference Abstract}}, number = {{Suppl 10}}, publisher = {{John Wiley & Sons Inc.}}, series = {{Arthritis & Rheumatology}}, title = {{Coronary Artery Disease in a Population-Based Cohort of Biopsy-Proven Giant Cell Arteritis in Southern Sweden}}, url = {{http://dx.doi.org/10.1002/art.41108}}, doi = {{10.1002/art.41108}}, volume = {{71}}, year = {{2019}}, }