Mediterr J Rheumatol 2019;30(3):171-6
Association between Takayasu arteritis and ischemic heart disease: a cohort study
Authors Information
1Department of Internal Medicine, Archet-1 Hospital, University of Nice-Sophia-Antipolis, Nice, France
2Department of Medicine ‘B’, Sheba Medical Center, Tel Hashomer, Israel
3Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
4Sackler Faculty of Medicine, Tel-Aviv University, Israel
5Department of Quality Measurements and Research, Chief Physician’s Office, Clalit Health Services, Tel Aviv, Israel
6Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
7Department of Dermatology and Venereology, Soroka Medical Center, Beer-Sheva, Israel
8Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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.