Statin Therapy Does not Seem to Benefit Giant Cell Arteritis

Narváez, Javier; Bernad, Berta; Nolla, Joan M.; Valverde, José

doi:10.1016/j.semarthrit.2006.10.001

Cited by 58 publications

(32 citation statements)

References 27 publications

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“…Moreover, similarly to what had been previously observed in patients with GCA, statin therapy failed to prevent ischemic events in TA patients in the present study. 23 Nevertheless, accelerated atherosclerosis has been well recognized in TA patients either through autopsy studies or noninvasive methods. [24][25][26][27] This finding has been highlighted by the higher frequency of risk factors for CVD such as systemic hypertension, high total cholesterol, low HDL and triglycerides in TA patients when compared to controls.…”

Section: De Souza Aws Et Almentioning

confidence: 99%

Antiplatelet Therapy for the Prevention of Arterial Ischemic Events in Takayasu Arteritis

Souza

Machado

Pereira

et al. 2010

Circ J

108

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Background: Vessel wall inflammation, atherosclerosis and hypercoagulability may be responsible for ischemic events in Takayasu arteritis (TA). No study has evaluated the effect of antiplatelet therapy for the prevention of ischemic events in TA. Methods and Results:Forty-eight patients who met the ACR Classification Criteria for TA under follow-up at the Vasculitis Unit of Universidade Federal de São Paulo were evaluated retrospectively for clinical manifestations, therapy and arterial ischemic events. The mean age at study was 38.0 years and the mean age at TA diagnosis was 29.1 years. Women comprised for 89.6% of patients and 60.4% were Caucasian. Risk factors for cardiovascular disease were found in 44 patients (91.7%) The most common comorbidities for TA patients were hypertension (77.1%), high low-density lipoprotein (45.8%) and obesity (16.7%). Antiplatelet therapy was used by 62.5% of patients whereas anticoagulants were used by 12.5%. Acute ischemic events occurred in 29.2% of patients. TA patients with ischemic events used significantly less antiplatelet agents (14.3%) than those without ischemic events (82.4%), P<0.0001. No difference concerning ischemic events was observed in patients on anticoagulant therapy (P=0.339). The 3 deaths of TA patients were observed only in those who had presented ischemic events (P=0.021). Antiplatelet agents had a protective effect against ischemic events (hazard ratio =0.055, 95% confidence interval: 0.06-0.514; P=0.011). Conclusions:Antiplatelet therapy is associated with a lower frequency of ischemic events in patients with TA. Antiplatelet Therapy in Takayasu Arteritis review of medical records of forty-eight patients who fulfilled the 1990 American College of Rheumatology criteria for TA and were under regular follow-up at the Vasculitis Unit in the Universidade Federal de São Paulo (Unifesp). 13 All of the 52 TA patients registered at our Vasculitis Unit were screened for this study, but 4 of them had to be excluded due to incomplete medical records. Medical appointments were scheduled within every one to 3 months in order to evaluate patients for the activity and progression of TA. Blood samples were collected before each visit for complete blood counts, erythrocyte sedimentation rates, lipid profiles, fasting glucose, liver enzymes and renal function. The decision to prescribe aspirin was made by the assistant physician. Statins were prescribed when serum low-density lipoprotein (LDL) levels exceeded 130 mg/dl.The present study was approved by the Institutional Ethics Committee. We collected information about demographic characteristics, disease features, arteriographic classification of TA, risk factors for cardiovascular diseases (CVD), acute ischemic events and medication used by the patients, including corticosteroids, immunosuppressive drugs, statins, anticoagulant and antiplatelet therapy. 14 The commencement dates for antiplatelet and anticoagulant therapy and of acute ischemic events were collected carefully. Time since the onset of symptoms suggestive o...

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Section: De Souza Aws Et Almentioning

confidence: 99%

Antiplatelet Therapy for the Prevention of Arterial Ischemic Events in Takayasu Arteritis

Souza

Machado

Pereira

et al. 2010

Circ J

108

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“…Azathioprine and other traditional DMARDs have not been shown to exert any favorable effects in GCA (293,294,295), although some steroid sparing effect of azathioprine was found in one double-blind study (293). Similarly, statin therapy does not seem to offer any protection against development of visual complications, large vessel vasculitis, jaw claudication, ischemic heart disease, or cerebrovascular accidents (296). TNF has been demonstrated in up to 60% of the cells in all areas of inflamed arteries (297), and inhibition of this cytokine may be an attractive therapeutic option in GCA.…”

Section: Alternative Treatment Strategiesmentioning

confidence: 99%

Diagnosis and Treatment of Giant Cell Arteritis (Temporal Arteritis) – Past, Current and Future Aspects

Gran¹

2011

Advances in the Diagnosis and Treatment of Vasculitis

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“…Two small studies failed to confirm the efficacy of statins in reducing ischemic complications or relapse rates in GCA 14,15 . However, benefits of statins in GCA cannot be excluded due to limitations of the studies 14 , and statin therapy should be considered in patients with GCA, given the increased cardiovascular risk of prolonged steroid treatment and the elderly patient population.…”

Section: Rheumatologymentioning

confidence: 99%