Coronary artery calcification in Takayasu's arteritis: clinical characteristics and risk factors

Clin Exp Rheumatol. 2024 Apr;42(4):843-851. doi: 10.55563/clinexprheumatol/ypq2lj. Epub 2024 Apr 11.

Abstract

Objectives: Coronary artery calcification (CAC) is frequently observed in Takayasu's arteritis (TAK). Our objective is to calculate the prevalence and severity of CAC in TAK, while evaluating the influence of traditional cardiovascular risk factors, glucocorticoid exposure, and disease activity on CAC.

Methods: This retrospective study involved 155 TAK patients. We measured the Agatston score by coronary computed tomography angiography (CCTA) and categorised all patients into groups with or without CAC (41 vs. 114) to compare clinical characteristics and ancillary findings between the two groups.

Results: Among the TAK patients, a total of 41 TAK patients (26.45%) exhibited CAC. Age of onset, disease duration, history of hypertension, history of hyperlipidaemia, Numano V and glucocorticoid use emerged as the independent risk factors for developing CAC in TAK (OR [95% CI] 1.084[1.028-1.142], p=0.003; 1.005 [1.001-1.010], p=0.020; 4.792 [1.713-13.411], p=0.003; 4.199 [1.087-16.219], p=0.037; 3.287 [1.070-10.100], p=0.038; 3.558[1.269-9.977], p=0.016). Nonetheless, CAC was not associated with disease activity. Moreover, the extent of calcification score in TAK showed a positive correlation with the number of traditional cardiovascular risk factors.

Conclusions: We recommend CCTA screening for Numano V classified TAK patients. Glucocorticoid usage significantly escalates the risk of CAC. Therefore, in cases of effectively controlled disease, the inclusion of immunosuppressants aimed at reducing glucocorticoid dosage is advisable.

MeSH terms

  • Adult
  • Computed Tomography Angiography*
  • Coronary Angiography*
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / epidemiology
  • Coronary Artery Disease* / etiology
  • Female
  • Glucocorticoids / adverse effects
  • Glucocorticoids / therapeutic use
  • Heart Disease Risk Factors
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Takayasu Arteritis* / complications
  • Takayasu Arteritis* / diagnostic imaging
  • Takayasu Arteritis* / drug therapy
  • Takayasu Arteritis* / epidemiology
  • Vascular Calcification* / diagnostic imaging
  • Vascular Calcification* / epidemiology
  • Young Adult

Substances

  • Glucocorticoids