Association between Takayasu arteritis and ischemic heart disease: a cohort study

Mediterr J Rheumatol. 2019 Sep 30;30(3):171-176. doi: 10.31138/mjr.30.3.171. eCollection 2019 Sep.

Abstract

Purpose of the study: Takayasu arteritis (TA) is an idiopathic large vessel vasculitis, which involves the aorta and its major branches. Our aim was to examine the association between TA and the development of ischemic heart disease (IHD) and its impact on survival.

Study design: Using data from Clalit Health Services (CHS), the largest Health Maintenance Organization (HMO) in Israel, the proportion of IHD was compared between patients diagnosed with TA and age- and gender-matched controls. Chi-square and t-tests were used for univariate analysis, and a logistic regression model was employed for multivariate analysis. Survival analysis was performed using Kaplan-Meier plots and cox regression.

Results: The study included 155 TA patients and 755 age- and gender-frequency matched controls. The proportion of IHD in TA patients was increased in comparison with controls (32.3% and 8.9%, p<0.001). In multivariate analysis, IHD was associated with TA (OR=6.576, 95% CI: 4.09-10.64) and male gender (OR=2.29, 95% CI: 1.43-4.26). Survival analysis over 15 years of follow-up showed a higher proportion of all-causes mortality in the TA group. In a multivariate analysis, TA (HR=2.58, 95%CI: 1.64-4.06) and IHD (HR=1.64, 95%CI: 1.05-2.55) were found to be associated with reduced survival.

Conclusions: TA patients present an increased proportion of IHD, and a reduced 15-years survival rate compared to controls.

Keywords: Takayasu arteritis; immune diseases; ischemic heart disease; vasculitis.