Generic placeholder image

Current Vascular Pharmacology

Editor-in-Chief

ISSN (Print): 1570-1611
ISSN (Online): 1875-6212

Research Article

Male Patients with Takayasu Arteritis and Coronary Artery Involvement are Prone to Have Serious Coronary Stenosis and High Mortality

Author(s): Weiping Ci*, Yinan Zhao and Tao Bi

Volume 20, Issue 1, 2022

Published on: 20 July, 2021

Page: [62 - 68] Pages: 7

DOI: 10.2174/1570161119666210720114939

Price: $65

Abstract

Background: Takayasu arteritis (TAK) is a rare autoimmune vasculitis that predominantly affects the aorta and its major branches, including the coronary arteries. Information is limited regarding sex-specific differences in coronary artery involvement among TAK patients.

Objective: To assess the differences in coronary angiographic findings and long-term outcomes between male and female TAK patients with coronary artery involvement.

Methods: This retrospective cohort study included 87 TAK patients, grouped by sex, who underwent coronary angiography. General characteristics, clinical features, coronary angiographic findings, and therapeutic strategies were obtained from medical records. Major Adverse Cardiac Events (MACE), including death from any cause, myocardial infarction, repeated coronary artery revascularization, and rehospitalization due to unstable or progressive angina or heart failure occurring during follow-up, were also recorded.

Results: A total of 207 coronary lesions with stenosis were found in 87 TAK patients. The prevalence of ostial coronary lesions was lower in men than in women (9.1 vs. 23.9%, p=0.031). We observed less moderate stenosis (6.8 vs. 22.7%, p=0.018) and more severe stenosis or occlusion (70.5 vs. 46.0%, p=0.004) in the coronary lesions of male TAK patients. During the up to 7-year follow- up, death from any cause was greater in men than in women (21.4 vs. 1.5%, p=0.003); no other significant differences in MACE occurrence were observed between sexes.

Conclusion: Among TAK patients with coronary artery involvement, males tend to have more serious coronary stenosis and a higher risk for long-term mortality than females.

Keywords: Coronary angiography, coronary artery, major adverse cardiac events (MACE), mortality, sex, Takayasu arteritis.

Graphical Abstract

[1]
Serra R, Butrico L, Fugetto F, et al. Updates in pathophysiology, diagnosis and management of Takayasu arteritis. Ann Vasc Surg 2016; 35: 210-25.
[http://dx.doi.org/10.1016/j.avsg.2016.02.011] [PMID: 27238990]
[2]
Rav-Acha M, Plot L, Peled N, Amital H. Coronary involvement in Takayasu’s arteritis. Autoimmun Rev 2007; 6(8): 566-71.
[http://dx.doi.org/10.1016/j.autrev.2007.04.001] [PMID: 17854750]
[3]
Li J, Zhu M, Li M, et al. Cause of death in Chinese Takayasu arteritis patients. Medicine (Baltimore) 2016; 95(27): e4069.
[http://dx.doi.org/10.1097/MD.0000000000004069] [PMID: 27399093]
[4]
Comarmond C, Biard L, Lambert M, et al. Long-term outcomes and prognostic factors of complications in Takayasu arteritis: A multicenter study of 318 patients. Circulation 2017; 136(12): 1114-22.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.116.027094] [PMID: 28701469]
[5]
Park SJ, Kim HJ, Park H, et al. Incidence, prevalence, mortality and causes of death in Takayasu Arteritis in Korea - A nationwide, population-based study. Int J Cardiol 2017; 235: 100-4.
[http://dx.doi.org/10.1016/j.ijcard.2017.02.086] [PMID: 28283361]
[6]
Soto ME, Espinola-Zavaleta N, Ramirez-Quito O, Reyes PA. Echocardiographic follow-up of patients with Takayasu’s arteritis: Five-year survival. Echocardiography 2006; 23(5): 353-60.
[http://dx.doi.org/10.1111/j.1540-8175.2006.00238.x] [PMID: 16686616]
[7]
Seyahi E. Takayasu arteritis: An update. Curr Opin Rheumatol 2017; 29(1): 51-6.
[http://dx.doi.org/10.1097/BOR.0000000000000343] [PMID: 27748689]
[8]
Lim AY, Lee GY, Jang SY, et al. Gender differences in clinical and angiographic findings of patients with Takayasu arteritis. Clin Exp Rheumatol 2015; 33(2)(Suppl. 89): S-132-7.
[PMID: 26016764]
[9]
Tomelleri A, Campochiaro C, Sartorelli S, et al. Gender differences in clinical presentation and vascular pattern in patients with Takayasu arteritis. Scand J Rheumatol 2019; 48(6): 482-90.
[http://dx.doi.org/10.1080/03009742.2019.1581838] [PMID: 31064248]
[10]
Wan J, Qi S, Liao H, Ci W, Guo Y, Wang T. Comparison of clinical features at the onset of Takayasu’s arteritis according to age and sex. Curr Vasc Pharmacol 2020; 18(1): 80-6.
[http://dx.doi.org/10.2174/1570161117666190621152506] [PMID: 31223091]
[11]
Arend WP, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum 1990; 33(8): 1129-34.
[http://dx.doi.org/10.1002/art.1780330811] [PMID: 1975175]
[12]
Kerr GS, Hallahan CW, Giordano J, et al. Takayasu arteritis. Ann Intern Med 1994; 120(11): 919-29.
[http://dx.doi.org/10.7326/0003-4819-120-11-199406010-00004] [PMID: 7909656]
[13]
Misra R, Danda D, Rajappa SM, et al. Development and initial validation of the Indian Takayasu Clinical Activity Score (ITAS2010). Rheumatology (Oxford) 2013; 52(10): 1795-801.
[http://dx.doi.org/10.1093/rheumatology/ket128] [PMID: 23594468]
[14]
Cury RC, Abbara S, Achenbach S, et al. CAD-RADS(TM) coronary artery disease - reporting and data system. An expert consensus document of the society of cardiovascular computed tomography (SCCT), the American college of radiology (ACR) and the north American society for cardiovascular imaging (NASCI). J Cardiovasc Comput Tomogr 2016; 10(4): 269-81.
[http://dx.doi.org/10.1016/j.jcct.2016.04.005] [PMID: 27318587]
[15]
Katsuyama T, Sada KE, Makino H. Current concept and epidemiology of systemic vasculitides. Allergol Int 2014; 63(4): 505-13.
[http://dx.doi.org/10.2332/allergolint.14-RAI-0778] [PMID: 25339434]
[16]
Zhang Z, Wang W, Zhou M, Lu PYJ, Li Y, Chen Y. An observational study of sex differences in Takayasu arteritis in China: Implications for worldwide regional differences. Ann Vasc Surg 2020; 66: 309-17.
[http://dx.doi.org/10.1016/j.avsg.2019.12.007] [PMID: 31863951]
[17]
Wang Y, Jia SJ, Zhou Y, et al. A study on the risk factors of coronary artery disease in patients with Takayasu arteritis. J Thorac Dis 2020; 12(5): 2031-8.
[http://dx.doi.org/10.21037/jtd-20-267] [PMID: 32642105]
[18]
Alibaz-Oner F, Koster MJ, Unal AU, et al. Assessment of the frequency of cardiovascular risk factors in patients with Takayasu’s arteritis. Rheumatology (Oxford) 2017; 56(11): 1939-44.
[http://dx.doi.org/10.1093/rheumatology/kex300] [PMID: 28968808]
[19]
Li J, Li H, Sun F, et al. Clinical characteristics of heart involvement in Chinese patients with Takayasu arteritis. J Rheumatol 2017; 44(12): 1867-74.
[http://dx.doi.org/10.3899/jrheum.161514] [PMID: 28811356]
[20]
Soulaidopoulos S, Madenidou AV, Daoussis D, et al. Cardiovascular Disease in the Systemic Vasculitides. Curr Vasc Pharmacol 2020; 18(5): 463-72.
[http://dx.doi.org/10.2174/1570161118666200130093432] [PMID: 32000652]
[21]
Matsubara O, Kuwata T, Nemoto T, Kasuga T, Numano F. Coronary artery lesions in Takayasu arteritis: Pathological considerations. Heart Vessels Suppl 1992; 7: 26-31.
[http://dx.doi.org/10.1007/BF01744540] [PMID: 1360966]
[22]
Verma SK, Kumar B, Bahl VK. Aorto-ostial atherosclerotic coronary artery disease-Risk factor profiles, demographic & angiographic features. Int J Cardiol Heart Vasc 2016; 12: 26-31.
[http://dx.doi.org/10.1016/j.ijcha.2016.05.016] [PMID: 28616538]
[23]
Arnaud L, Haroche J, Toledano D, et al. Cluster analysis of arterial involvement in Takayasu arteritis reveals symmetric extension of the lesions in paired arterial beds. Arthritis Rheum 2011; 63(4): 1136-40.
[http://dx.doi.org/10.1002/art.30240] [PMID: 21452331]
[24]
Stone JR, Bruneval P, Angelini A, et al. Consensus statement on surgical pathology of the aorta from the Society for cardiovascular pathology and the association for European cardiovascular pathology: I. Inflammatory diseases. Cardiovasc Pathol 2015; 24(5): 267-78.
[http://dx.doi.org/10.1016/j.carpath.2015.05.001] [PMID: 26051917]
[25]
Hellmich B, Agueda A, Monti S, et al. 2018 Update of the EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis 2020; 79(1): 19-30.
[http://dx.doi.org/10.1136/annrheumdis-2019-215672] [PMID: 31270110]
[26]
Huang Z, Zhang H, Wang M, Yang W, Qiao S, Hu F. Revascularization versus medical therapy in Takayasu’s arteritis patients with coronary artery involvement. Rheumatol Ther 2021; 8(1): 119-33.
[http://dx.doi.org/10.1007/s40744-020-00251-2] [PMID: 33230786]
[27]
Wang X, Dang A, Lv N, et al. Long-term outcomes of coronary artery bypass grafting versus percutaneous coronary intervention for Takayasu arteritis patients with coronary artery involvement. Semin Arthritis Rheum 2017; 47(2): 247-52.
[http://dx.doi.org/10.1016/j.semarthrit.2017.03.009] [PMID: 28457530]
[28]
Mathur P, Ostadal B, Romeo F, Mehta JL. Gender-related differences in atherosclerosis. Cardiovasc Drugs Ther 2015; 29(4): 319-27.
[http://dx.doi.org/10.1007/s10557-015-6596-3] [PMID: 26006701]
[29]
Wang H, Zhang Y, Shen Z, Fang L, Liu Z, Zhang S. Comparing the effects of different management strategies on long-term outcomes for significant coronary stenosis in patients with Takayasu arteritis. Int J Cardiol 2020; 306: 1-7.
[http://dx.doi.org/10.1016/j.ijcard.2020.02.051] [PMID: 32115273]
[30]
Khamis RY, Ammari T, Mikhail GW. Gender differences in coronary heart disease. Heart 2016; 102(14): 1142-9.
[http://dx.doi.org/10.1136/heartjnl-2014-306463] [PMID: 27126397]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy