| Title: | Age, anticoagulants, hypertension and cardiovascular genetic traits predict cranial ischaemic complications in patients with giant cell arteritis |
| Journal: | Annals of the Rheumatic Diseases |
| Published: | 2 Jan 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/39919905/ |
| DOI: | https://doi.org/10.1136/ard-2024-225515 |
Publication 14862
WARNING: the interactive features of this website use CSS3, which your browser does not support. To use the full features of this website, please update your browser.
Abstract
OBJECTIVES: This project aimed to determine whether cranial ischaemic complications at the presentation of giant cell arteritis (GCA) were associated with pre-existing cardiovascular (CV) risk factors, CV disease or genetic risk of CV-related traits.</p>
METHODS: 1946 GCA patients with clinicodemographic data at GCA presentation were included. Associations between pre-existing CV-related traits (including Polygenic Risk Scores (PRS) for CV traits) and cranial ischaemic complications were tested. A model for cranial ischaemic complications was optimised using an elastic net approach. Positional gene mapping of associated PRS was performed to improve biological understanding.</p>
RESULTS: In a sample of 1946 GCA patients (median age=71, 68.7% female), 17% had cranial ischaemic complications at presentation. In univariable analyses, 10 variables were associated with complications (likelihood-ratio test p≤0.05). In multivariable analysis, the two variables with the strongest effects, with or without PRS in the model, were anticoagulant therapy (adjusted OR (95% CI)=0.21 (0.05 to 0.62), p=4.95×10-3) and age (adjusted OR (95% CI)=1.60 (0.73 to 3.66), p=2.52×10-3, for ≥80 years versus <60 years). In sensitivity analyses omitting anticoagulant therapy from multivariable analysis, age and hypertension were associated with cranial ischaemic complications at presentation (hypertension: adjusted OR (95% CI)=1.35 (1.03 to 1.75), p=0.03). Positional gene mapping of an associated transient ischaemic attack PRS identified TEK, CD96 and MROH9 loci.</p>
CONCLUSION: Age and hypertension were risk factors for cranial ischaemic complications at GCA presentation, but in this dataset, anticoagulation appeared protective. Positional gene mapping suggested a role for immune and coagulation-related pathways in the pathogenesis of complications. Further studies are needed before implementation in clinical practice.</p>
14 Keywords
- Age Factors
- Aged
- Aged, 80 and over
- Anticoagulants
- Brain Ischemia
- Female
- Genetic Predisposition to Disease
- Giant Cell Arteritis
- Heart Disease Risk Factors
- Humans
- Hypertension
- Male
- Middle Aged
- Risk Factors
13 Authors
- Natalie J.M. Chaddock
- Charlotte J. Harden
- Louise Sorensen
- Hannah R. Mathieson
- Michal Zulcinski
- Catherine A. Lawson
- Eoin O'Sullivan
- Susan P. Mollan
- Javier Martin
- Sarah L. Mackie
- Mark M. Iles
- Ann W. Morgan
- GCA Consortium
1 Application
| Application ID | Title |
|---|---|
| 24559 | Weighing benefits and risks of therapies for the treatment of chronic inflammatory diseases |
Enabling scientific discoveries that improve human health