Format

Send to

Choose Destination
J Autoimmun. 2018 Aug 16. pii: S0896-8411(18)30368-8. doi: 10.1016/j.jaut.2018.08.001. [Epub ahead of print]

Overall survival and mortality risk factors in Takayasu's arteritis: A multicenter study of 318 patients.

Author information

1
Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, Inflammation-Immunopathology-Biotherapy Department (DHU i2B), F-75005, Paris, France; INSERM, UMR_S 959, F-75013, Paris, France; CNRS, FRE3632, F-75005, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, F-75013, Paris, France; Centre de Référence des Maladies Auto-Immunes et Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose, France.
2
AP-HP, SBIM, Hôpital Saint-Louis, Université Paris Diderot, Paris 7, Paris, France; INSERM, ECSTRA Team, CRESS UMR-S 1153, 75010, Paris, France.
3
Hôpital Claude Huriez, Service de Médecine Interne, Centre de Référence des Maladies Auto-Immunes et Systémiques Rares du Nord et Nord-Ouest (CeRAINAO), CHU, Université de Lille, Lille, France.
4
Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, Inflammation-Immunopathology-Biotherapy Department (DHU i2B), F-75005, Paris, France; Department of Internal Medicine - Hôpitaux de Paris, Hôpital Saint-Antoine, 184, rue du Faubourg Saint-Antoine, 75012, Paris, France; UPMC University Paris 06, Paris, France.
5
Service de Médecine Interne, Hôpital Foch, Suresnes, France.
6
Service de Médecine Interne, CHU de Rouen, Rouen, France.
7
AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Chirurgie Vasculaire, UPMC-Paris VI, Paris, France.
8
AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département d'Imagerie CardioVasculaire et de Radiologie Interventionnelle, UPMC Paris VI, INSERM-CNRS-LIB, Paris, France.
9
AP-HP, Hôpital Européen Georges-Pompidou, Service de Médecine vasculaire, INSERM UMR970, PARCC, Centre de référence des maladies vasculaires rares, DHU pathologies artérielles rares et communes, Hôpitaux Universitaires Paris Ouest, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
10
Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, Inflammation-Immunopathology-Biotherapy Department (DHU i2B), F-75005, Paris, France; INSERM, UMR_S 959, F-75013, Paris, France; CNRS, FRE3632, F-75005, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, F-75013, Paris, France; Centre de Référence des Maladies Auto-Immunes et Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose, France. Electronic address: david.saadoun@aphp.fr.

Abstract

OBJECTIVE:

To report the long term mortality in Takayasu arteritis (TA) and to identify prognosis factors.

METHODS:

We analyzed the causes of death and the factors associated with mortality in a cohort of 318 patients [median age at diagnosis was 36 [25-47] years and 276 (86%) patients were women] fulfilling American College of Rheumatology and/or Ishikawa criteria of TA. A prognostic score for death and vascular complications was elaborated based on a multivariate model.

RESULTS:

Among 318 TA patients, 16 (5%) died after a median [IQR] follow-up of 6.1 [2.8-13.0] years. The median age at death was 38 [25-47] years with 88% of women. Main causes of death included mesenteric ischemia (n = 4, 25%) and aortic aneurysm rupture (n = 4, 25%). The mortality rate at 5 and 10 years was of 1.9% and 3.9%, respectively. Caucasians (p = 0.049) and smokers (p = 0.002) TA patients were more likely to die. There was an increased mortality in TA (SMR with 95% confidence interval, 2.73 [1.69-4.22]) as compared to age and sex matched healthy controls. We defined high risk patients for death and vascular complications according to the presence of two of the following factors (i.e a progressive clinical course, thoracic aorta involvement and/or retinopathy). In the high risk TA group, the 5-year incidence of death and vascular complication was 48.5% compared to 21.6% (p = 0.001) in those with low risk.

CONCLUSION:

The overall mortality in our Takayasu cohort was 5% after a median follow-up of 6.1 years. We identified specific characteristics that distinguish TA patients at highest risk for death and vascular complications.

KEYWORDS:

Epidemiology; Mortality risk factors; Takayasu arteritis; Vasculitis

PMID:
30122419
DOI:
10.1016/j.jaut.2018.08.001

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center