Atherosclerosis in Takayasu arteritis

Seyahi, Emire; Uğurlu, Serdal; Cumali, Rana; Balcı, Huriye; Seyahi, Nurhan; Yurdakul, Sebahattin; Yazıcı, Hasan

doi:10.1136/ard.2005.047498

Cited by 153 publications

(112 citation statements)

References 36 publications

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“…Notably, diabetes and hypertension are much more common in patients with vasculitis [30,50,56]. These findings are related probably to the therapeutic regimen that is used for vasculitis [21].…”

Section: Pathophysiology Of Accelerated Atherosclerosis In Vasculitismentioning

confidence: 92%

“…It has been demonstrated recently that patients with Wegener's granulomatosis gained 7·3% weight during the first year after diagnosis and approximately 20% of the patients gained more than 10 kg in the first year of treatment [59]. However, compared with the background population the number of patients with obesity does not seem to be increased [30,50]. Finally, impaired renal function, persistent proteinuria and increased levels of C-reactive protein are also important risk factors for cardiovascular events in patients with vasculitis that are clearly more prevalent than in the background population.…”

Section: Pathophysiology Of Accelerated Atherosclerosis In Vasculitismentioning

confidence: 92%

“…In autopsy reports in young patients with Takayasu arteritis, atherosclerotic changes have been well documented [32]. In a recent study, Seyahi et al performed ultrasonography in 30 female patients with Takayasu arteritis [30]. Atherosclerotic plaques in the carotid artery were present in 27% of the patients and in only 2% of the age-and sex-matched controls.…”

Section: Occurrence Of Accelerated Atherosclerosis In Vasculitismentioning

confidence: 99%

“…In Takayasu arteritis accelerated atherosclerosis has been documented clearly [29][30][31]. In autopsy reports in young patients with Takayasu arteritis, atherosclerotic changes have been well documented [32].…”

Section: Occurrence Of Accelerated Atherosclerosis In Vasculitismentioning

confidence: 99%

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Translational Mini-Review Series on Immunology of Vascular Disease: Accelerated atherosclerosis in vasculitis

Tervaert

2009

Clinical and Experimental Immunology

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SummaryPremature atherosclerosis has been observed during the course of different systemic inflammatory diseases such as rheumatoid arthritis and sytemic lupus erythematosus. Remarkably, relatively few studies have been published on the occurrence of accelerated atherosclerosis in patients with vasculitis. In giant cell arteritis (GCA), mortality because of ischaemic heart disease is not increased. In addition, intima media thickness (IMT) is lower in patients with GCA than in age-matched controls. In contrast, IMT is increased significantly in Takayasu arteritis, another form of large vessel vasculitis occurring in younger patients. In Takayasu arteritis and in Kawasaki disease, a form of medium-sized vessel vasculitis, accelerated atherosclerosis has been well documented. In small vessel vasculitis because of anti-neutrophil cytoplasmic autoantibodies-associated vasculitis, cardiovascular diseases are a major cause of mortality. IMT measurements reveal conflicting results. During active disease these patients experience acceleration of the atherosclerotic process. However, when inflammation is controlled, these patients have atherosclerotic development as in healthy subjects. Several risk factors, such as diabetes and hypertension, are present more often in patients with vasculitis compared with healthy controls. In addition, steroids may be pro-atherogenic. Most importantly, many patients have impaired renal function, persistent proteinuria and increased levels of C-reactive protein, well-known risk factors for acceleration of atherosclerosis. Enhanced oxidation processes, persistently activated T cells and reduced numbers of regulatory T cells are among the many pathophysiological factors that play a role during acceleration of atherogenesis. Finally, autoantibodies that may be relevant for acceleration of atherosclerosis are found frequently in elevated titres in patients with vasculitis. Because patients have an increased risk for cardiovascular events, vasculitis should be treated with as much care as possible. In addition, treatment should be considered with angiotensin-converting-enzyme inhibitors and/or angiotensin receptor-1 blockers, statins and acetylsalicyl acid. Finally, classical risk factors for cardiovascular disease should be monitored and treated as much as possible.

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Section: Pathophysiology Of Accelerated Atherosclerosis In Vasculitismentioning

confidence: 92%

Section: Pathophysiology Of Accelerated Atherosclerosis In Vasculitismentioning

confidence: 92%

Section: Occurrence Of Accelerated Atherosclerosis In Vasculitismentioning

confidence: 99%

Section: Occurrence Of Accelerated Atherosclerosis In Vasculitismentioning

confidence: 99%

See 2 more Smart Citations

Translational Mini-Review Series on Immunology of Vascular Disease: Accelerated atherosclerosis in vasculitis

Tervaert

2009

Clinical and Experimental Immunology

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“…In patients with Takayasu arteries, the pathological changes of pulmonary arteries were similar to systemic artery involvements, which include granulomatous panarteritis with adventitial thickening, cellular infiltration of the tunica media, intimal hyperplasia from myofibroblast proliferation, and lumen stenosis and occlusion from fibrosis of the tunica media and intima 16, 17. The ultrasound characteristic of arteritis was the “macaroni sign,” which was described as diffuse homogeneous echoic circumferential vessel wall thickening 18.…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic characteristics of pulmonary artery involvement in Takayasu arteritis

Jiang

Yang

et al. 2017

Echocardiography

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BackgroundUp to 50% patients with Takayasu arteritis have pulmonary artery involvement. Hence, the early identification of pulmonary artery involvement to facilitate prompt treatment is required.MethodsThis retrospective study was performed in patients diagnosed with Takayasu arteritis between January 2009 and January 2016. Pulmonary artery involvement was confirmed with computed tomographic pulmonary angiography. Images from transthoracic echocardiography in three windows (suprasternal right pulmonary artery long‐axis view, parasternal aortic short‐axis view, and subxiphoid view) were documented and analyzed.ResultsA total of 27 patients had Takayasu arteritis and pulmonary artery involvement. Characteristic changes identified by echocardiography included luminal medium‐to‐high echogenic signals, stenosis, and occlusion, as well as intimal thickening. Left pulmonary artery involvement was revealed in the parasternal aortic short‐axis view. Right pulmonary artery involvement was best observed in the suprasternal right pulmonary artery long‐axis view, with complementary views from the parasternal aortic short‐axis and subxiphoid angles. Pulmonary trunk involvement was not observed in all three windows.ConclusionsTransthoracic echocardiography could be a useful noninvasive test to detect pulmonary artery involvement in patients with Takayasu arteritis.

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Prognostic Value of Brachial–Ankle Pulse Wave Velocity in Patients With Takayasu Arteritis With Drug‐Eluting Stent Implantation

Wang

Dang

2015

Arthritis Care & Research

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Objective. This study investigates the long-term outcomes of drug-eluting stent (DES) implantation in patients with Takayasu arteritis (TAK). Methods. Data on 48 TAK patients and 40 age-, sex-, and severity-matched patients with coronary artery disease (CAD) receiving DES implantation and hospitalized in Fuwai Hospital from February 2004 to March 2014 were assessed. The clinical features, laboratory data, coronary angiographic findings, treatment, and followup outcomes were summarized retrospectively. Major adverse cardiac events (MACE), which include all-cause death, nonfatal myocardial infarction, and nonfatal target vessel revascularization, were recorded. Results. TAK patients exhibited increased mean 6 SD brachial-ankle pulse wave velocity (baPWV) compared with patients with CAD (17.0 6 3.8 versus 13.8 6 3.0 meters/second; P 5 0.002). However, CAD patients had higher levels of lowdensity lipoprotein cholesterol (2.5 6 1.0 versus 2.3 6 0.8 mmoles/liter; P 5 0.04). Multiple linear regression analysis revealed that baPWV was independently associated with the extent of CAD, assessed by the SYNTAX (Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery) score (b 5 0.33, P 5 0.03), in TAK patients. DES implantation was deployed in 73 coronary lesions in 48 TAK patients, and restenosis occurred in 48 lesions after an average of 25.6 months (range 9.0-68.0 months) following intervention. Logistic regression analysis identified that a baPWV of 17.00 meters/second or higher (odds ratio 5.50, 95% confidence interval [95% CI] 2.1-16.6, P 5 0.008) may be considered as an independent predictor of DES restenosis. Moreover, the multivariate Cox proportional hazards model demonstrated that a baPWV of 17.00 meters/second or higher (hazard ratio 3.36, 95% CI 1.51-7.52, P 5 0.003) was significant and may serve as an independent predictor of MACE in TAK patients who underwent DES implantation. Conclusion. DES in-stent restenosis remains a challenge, affecting the long-term outcomes of patients with TAK. Measuring increased arterial stiffness through baPWV, with the addition of inflammation status monitoring during followup, would be of great clinical value to identify TAK patients with DES who have a high risk for in-stent restenosis and MACE.

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Atherosclerosis in Takayasu arteritis

Abstract: Patients with Takayasu arteritis have a high rate of atherosclerotic plaques, at least as frequent as that observed among patients with SLE.

Cited by 153 publications

References 36 publications

Translational Mini-Review Series on Immunology of Vascular Disease: Accelerated atherosclerosis in vasculitis

Translational Mini-Review Series on Immunology of Vascular Disease: Accelerated atherosclerosis in vasculitis

Echocardiographic characteristics of pulmonary artery involvement in Takayasu arteritis

Prognostic Value of Brachial–Ankle Pulse Wave Velocity in Patients With Takayasu Arteritis With Drug‐Eluting Stent Implantation

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