EULAR 2019 | Daily Highlights

CV risk in GPA

GRANULOMATOSIS WITH POLYANGIITIS, (GPA): CARDIOVASCULAR MORBIDITY AND MORTALITY IN A POPULATION-BASED COHORT. A DANISH REGISTER STUDY

Abstract: FRI0263
Authors: Helle Laustrup et al.

» zum Abstract

Key findings:
There is growing evidence that both premature and pronounced atherosclerosis is associated with ANCA associated vasculitis (AAV). A population-based cohort study was performed using Danish Registries. Annual incidence rate (IR), point prevalence (PP) and standardized mortality rate (SMR) were calculated. CV morbidity was divided into heart failure (HF) and myocardial infarction (MI). Death caused by CV disease was registered.

1829 individuals with GPA were identified. The median annual IR was 20.5/1,000,000 and PP was 277/1,000,000 in 2015. Overall SMR was 2.14.

Among patients with GPA 171 had a hospital diagnosis of MI. Compared to the control population, the hazard ratio (HR) of MI was 2.47 during the first 3 months. Between 3 months and one year it declined to 1.41, and after 10 years to 1.64. The risk of HF was markedly increased with a HR at 7.22 during the first 3 months. Again a decline was noted thereafter.

The total number of CV deaths in the GPA cohort was 307. During the first three months after a GPA diagnosis, the HR was increased to 9.51 declining to 2.51 after one year, but still increased to 1.56 after 10 years.

Relevance:
There was a striking temporal relation between a high HR of CV morbidity and mortality during the first year after the diagnosis of GPA, and, remarkably, the increased risk persisted over 10 years. The results indicate a strong association between systemic vascular inflammatory disease and CV involvement. They underline the importance to identify and continuously control cardio-vascular risk factors in patients with ANCA-vasculitides.

Zusammenfassung und Kommentar von:
Prof. Dr. Peter Villiger
Bern