High Incidence of Arterial and Venous Thrombosis in Antineutrophil Cytoplasmic Antibody–associated Vasculitis

Abstract

Objective.To determine the incidence of arterial thrombotic events (ATE) and venous thromboembolism (VTE) in antineutrophil cytoplasmic antibody–associated vasculitis (AAV).Methods.This is a retrospective cohort study presenting the incidence of ATE (coronary events or ischemic stroke) and VTE [pulmonary embolism (PE) or deep venous thrombosis (DVT)] in patients diagnosed with AAV between 2005 and 2014.Results.There were 204 patients with AAV who were identified. Median followup for surviving patients was 5.8 (range 1–10) years, accounting for 1088 person-years (PY). The incidence of ATE was 2.67/100 PY (1.56 for coronary events and 1.10 for ischemic stroke) and for VTE was 1.47/100 PY (0.83 for DVT only and 0.64 for PE with/without DVT). On multivariate analysis, prior ischemic heart disease (IHD) and advancing age were the only independent predictors of ATE. Among patients without prior IHD or stroke, the incidence of ATE remained elevated at 2.32/100 PY (1.26 for coronary events and 1.06 for ischemic stroke). ATE, but not VTE, was an independent predictor of all-cause mortality. Event rates for both ATE and VTE were highest in the first year after diagnosis of AAV but remained above the population incidence during the 10-year followup period. In comparison to reported rates for the UK population, the event rates in our AAV patients were 15-times higher for coronary events, 11-times higher for incident stroke, and 20-times higher for VTE.Conclusion.Patients with AAV have a high incidence of arterial and venous thrombosis, particularly in the first year after diagnosis.

Atherogenic index of plasma predicts cerebrovascular accident occurrence in antineutrophil cytoplasmic antibody-associated vasculitis

“…A long-term population-based study revealed that the risk of CVD and CVA in AAV patients were 3-and 8-fold higher than those in matched subjects [22]. In addition, a retrospective study that was performed in the United Kingdom has shown that AAV patients have high incidence of arterial and venous thrombosis [23]. Moreover, a meta-analysis by Houben et al demonstrated that the risk of developing cardiovascular events was higher in AAV patients compared to the general population [24].…”

Incidence and Risk Factors of Venous Thromboembolic Events in Patients with ANCA-Glomerulonephritis: A Cohort Study from the Maine-Anjou Registry

“…Venous thromboembolism (VTE) is a classical complication of chronic inflammatory diseases [ 1 ], reported to be increased in many auto-immune and rheumatic diseases, including ANCA-associated vasculitis (AAV) [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 ]. The first studies specifically addressed in AAV were a case series of pediatric patients that developed deep vein thrombosis (DVT) shortly after disease diagnosis [ 10 ] and a post-hoc analysis of the Wegener’s Granulomatosis Etanercept Trial (WGET) [ 2 , 11 ].…”

Atherogenic index of plasma predicts cerebrovascular accident occurrence in antineutrophil cytoplasmic antibody-associated vasculitis

“…A long-term populationbased study revealed that the risk of CVD and CVA in AAV patients were 3-and 8-fold higher than those in matched subjects [22]. In addition, a retrospective study that was performed in the United Kingdom has shown that AAV patients have high incidence of arterial and venous thrombosis [23]. Moreover, a meta-analysis by Houben et al demonstrated that the risk of developing cardiovascular events was higher in AAV patients compared to the general population [24].…”