Abstract
Introduction
: Granulomatosis with polyangiitis (GPA) is one of antineutrophil cytoplasmic autoantibody
(ANCA) – associated systemic vasculitis and is characterised by inflammation of blood
vessels. Systemic vasculitis exhibits an enhanced cardiovascular morbidity and cardiovascular
disease (CVD) has become a leading cause of death in this group of patients.
Objectives
: The aim of the present study was to assess the prevalence of clinical manifestation
of atherosclerosis and its relation with classic risk factors for atherosclerosis,
echocardiographic parameters and laboratory findings in GPA patients.
Patients and methods
: The group of consecutive patients with GPA were followed in the study.
Results
: One hundred six patients with GPA (mean age 50.4 ± 14.9 yrs, 67 female) were prospectively
followed for 5.1 ± 1.6 yrs. In 19 patients (18%) cardiovascular disease (9 acute coronary
syndromes, 4 symptomatic peripheral vascular diseases and 6 strokes) occurred in association
with GPA. In a multivariate model, only age was predictive of cardiovascular events
in this group of patients (OR=1.078, 95% CI: 1.025–1.134, p = 0.003). During observation in patients without CVD the level of hs-CRP and D-dimer were significantly reduced on the follow-up visit (p = 0.041, p = 0.0002). On the other hand, in patients with CV events there was no significant
differences in both markers’ concentrations despite clinical remission.
Conclusions
: The age was the only independent predictor of cardiovascular events. Persistent
elevation of inflammatory and prothrombotic markers despite clinical remission of
the disease could be an indicator of premature atherosclerosis development in patients
with systemic vasculitis.
Key words
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Article info
Publication history
Published online: May 30, 2021
Accepted:
May 11,
2021
Received:
March 17,
2021
Footnotes
☆The authors declare no conflict of interests
☆The authors have no funding to disclose
☆ClinicalTrials.gov identifier: NCT03782870
Identification
Copyright
© 2021 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
