The clinical characteristics of Malaysian patients with Takayasu Arteritis: A retrospective study of 3 decades

Abstract

Aim of the work

To understand the clinical features, angiographic involvement patterns and outcomes of Takayasu Arteritis (TA) in Malaysian patients.

Patients and methods

This was a retrospective study of 85 TA patients from 20 tertiary rheumatology centers in Malaysia from 1990 until 2020. Demographic information, clinical features, angiographic patterns, treatment and comorbidities were analyzed.

Results

The female-to-male ratio was 13.1:1. The age at disease onset was 27.47 ± 10.4 years. The duration of delay in diagnosis was 6 ± 27.5 months. 48.2 % were Malay, 12.9 % Chinese, 23.5 % Indian and 14.3 % other ethnicities. Hypertension emerged as the most common comorbidity (52.9 %), followed by dyslipidemia (29.4 %). The most prevalent angiographic pattern was Type V (55.3 %), with left subclavian artery (65.9 %) and left carotid (55.3 %) being the most commonly involved vessels. Glucocorticoids constituted the mainstay of treatment; however, approximately half of the patients required treatment with methotrexate and azathioprine. There were six deaths, primarily attributed to coronary artery disease and infections. Surgical interventions, including angioplasty and bypass surgery, were performed on 11 patients. Out of 44 pregnancies, 79.5 % were successful.

Conclusion

This study revealed a pattern of TA disease in Malaysia that aligns with findings from other cohort studies. The most prevalent angiographic type observed was type V, with the subclavian and carotid arteries being the most commonly involved vessels among TA patients in Malaysia. This research contributes to a better understanding of the clinical presentations observed over the past three decades, offering valuable insights for the improved management of TA patients in Malaysia.