Clinically Apparent Arterial Thrombosis in Persons with Systemic Vasculitis
Objective. To estimate the incidence rate of clinically apparent arterial thrombotic events and associated comorbidities in patients with primary systemic vasculitis. Methods. Using large cohort administrative data from Quebec, Canada, we identified patients with vasculitis, including polyarteritis...
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2017-01-01
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Series: | International Journal of Rheumatology |
Online Access: | http://dx.doi.org/10.1155/2017/3572768 |
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doaj-70c88ae976ae41309056fb003ed861322020-11-25T00:36:57ZengHindawi LimitedInternational Journal of Rheumatology1687-92601687-92792017-01-01201710.1155/2017/35727683572768Clinically Apparent Arterial Thrombosis in Persons with Systemic VasculitisAlexander Tsoukas0Sasha Bernatsky1Lawrence Joseph2David L. Buckeridge3Patrick Bélisle4Christian A. Pineau5Division of Rheumatology, Department of Medicine, McGill University Health Centre, Montreal, QC, CanadaDivision of Rheumatology, Department of Medicine, McGill University Health Centre, Montreal, QC, CanadaDivision of Clinical Epidemiology, Department of Medicine, McGill University Health Centre, Montreal, QC, CanadaMcGill Clinical and Health Informatics, McGill University, Montreal, QC, CanadaDivision of Clinical Epidemiology, Department of Medicine, McGill University Health Centre, Montreal, QC, CanadaDivision of Rheumatology, Department of Medicine, McGill University Health Centre, Montreal, QC, CanadaObjective. To estimate the incidence rate of clinically apparent arterial thrombotic events and associated comorbidities in patients with primary systemic vasculitis. Methods. Using large cohort administrative data from Quebec, Canada, we identified patients with vasculitis, including polyarteritis nodosa (PAN) and granulomatosis with polyangiitis (GPA). Incident acute myocardial infarctions (AMIs) and cerebrovascular accidents (CVAs) after the diagnosis of vasculitis were ascertained in the PAN and GPA group via billing and hospitalization data. These were compared to rates of a general population comparator group. The incidences of comorbidities (type 2 diabetes mellitus, dyslipidemia, and hypertension) were also collected. Results. Among the 626 patients identified with vasculitis, 19.7% had PAN, 2.9% had Kawasaki disease, 23.8% had GPA, 52.4% had GCA, and 1.3% had Takayasu arteritis. The AMI rate was substantially higher in males aged 18–44 with PAN, with rates up to 268.1 events per 10,000 patient years [95% CI 67.1–1070.2], approximately 30 times that in the age- and sex-matched control group. The CVA rate was also substantially higher, particularly in adults aged 45–65. Patients with vasculitis had elevated incidences of diabetes, dyslipidemia, and hypertension versus the general population. Conclusion. Atherothrombotic rates were elevated in patients identified as having primary systemic vasculitis. While incident rates of cardiovascular comorbidities were also increased, the substantial elevation in AMIs seen in young adults suggests a disease-specific component which requires further investigation.http://dx.doi.org/10.1155/2017/3572768 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Alexander Tsoukas Sasha Bernatsky Lawrence Joseph David L. Buckeridge Patrick Bélisle Christian A. Pineau |
spellingShingle |
Alexander Tsoukas Sasha Bernatsky Lawrence Joseph David L. Buckeridge Patrick Bélisle Christian A. Pineau Clinically Apparent Arterial Thrombosis in Persons with Systemic Vasculitis International Journal of Rheumatology |
author_facet |
Alexander Tsoukas Sasha Bernatsky Lawrence Joseph David L. Buckeridge Patrick Bélisle Christian A. Pineau |
author_sort |
Alexander Tsoukas |
title |
Clinically Apparent Arterial Thrombosis in Persons with Systemic Vasculitis |
title_short |
Clinically Apparent Arterial Thrombosis in Persons with Systemic Vasculitis |
title_full |
Clinically Apparent Arterial Thrombosis in Persons with Systemic Vasculitis |
title_fullStr |
Clinically Apparent Arterial Thrombosis in Persons with Systemic Vasculitis |
title_full_unstemmed |
Clinically Apparent Arterial Thrombosis in Persons with Systemic Vasculitis |
title_sort |
clinically apparent arterial thrombosis in persons with systemic vasculitis |
publisher |
Hindawi Limited |
series |
International Journal of Rheumatology |
issn |
1687-9260 1687-9279 |
publishDate |
2017-01-01 |
description |
Objective. To estimate the incidence rate of clinically apparent arterial thrombotic events and associated comorbidities in patients with primary systemic vasculitis. Methods. Using large cohort administrative data from Quebec, Canada, we identified patients with vasculitis, including polyarteritis nodosa (PAN) and granulomatosis with polyangiitis (GPA). Incident acute myocardial infarctions (AMIs) and cerebrovascular accidents (CVAs) after the diagnosis of vasculitis were ascertained in the PAN and GPA group via billing and hospitalization data. These were compared to rates of a general population comparator group. The incidences of comorbidities (type 2 diabetes mellitus, dyslipidemia, and hypertension) were also collected. Results. Among the 626 patients identified with vasculitis, 19.7% had PAN, 2.9% had Kawasaki disease, 23.8% had GPA, 52.4% had GCA, and 1.3% had Takayasu arteritis. The AMI rate was substantially higher in males aged 18–44 with PAN, with rates up to 268.1 events per 10,000 patient years [95% CI 67.1–1070.2], approximately 30 times that in the age- and sex-matched control group. The CVA rate was also substantially higher, particularly in adults aged 45–65. Patients with vasculitis had elevated incidences of diabetes, dyslipidemia, and hypertension versus the general population. Conclusion. Atherothrombotic rates were elevated in patients identified as having primary systemic vasculitis. While incident rates of cardiovascular comorbidities were also increased, the substantial elevation in AMIs seen in young adults suggests a disease-specific component which requires further investigation. |
url |
http://dx.doi.org/10.1155/2017/3572768 |
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