Giant cell arteritis (GCA) as a risk factor for seizures: a cohort study.

Paula David, Esther Houri Levi, Ariel Feifel, Yonatan Shneor Patt, Abdulla Watad, Omer Gendelman, Arnon D Cohen, Howard Amital, Avishai M Tsur
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Abstract

Objectives: The objective of this study was to assess the risk of seizures in Giant Cell Arteritis (GCA) patients in a large cohort of Israeli subjects, in comparison to matched controls.

Methods: Patients diagnosed with GCA between 2002 and 2017 were included. Controls were matched based on sex, age, socioeconomic status, country of birth, diabetes mellitus, and hypertension in a 4:1 ratio. Patients with seizure records prior to the study period were excluded. Hazard ratios for seizures was obtained by cox regression models.

Results: The study cohort was composed by 8,103 GCA patients and 32,412 matched controls. The GCA group included 5,535 women (68%), 2,644 patients born in Israel (33%), and 2,888 patients with low socioeconomic status (36%). The median age of this group was 71. During the followed cumulative person-years of 54,641 and 222,537 in the GCA and control group, respectively, 15.92 cases per 10,000 person-years was found in the GCA group, compared to 9.62 per 10,000 person-years in the controls. GCA was associated with seizures in the unadjusted (HR = 1.66, 95% CI [1.29 to 2.13]) and adjusted (HR = 1.67, 95% CI [1.3 to 2.14]) models. GCA was also associated with seizures after controlling for strokes (HR = 1.55, 95% CI [1.16 to 2.07]).

Conclusion: According to this study, individuals with GCA are at a higher risk of developing seizures when compared to the general population. This increased risk is independent of their predisposition for stroke. One proposed mechanism is that the GCA pro-inflammatory state may decrease the neuronal threshold for depolarization.

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巨细胞动脉炎(GCA)是癫痫发作的危险因素:一项队列研究。
研究目的本研究的目的是评估一大批以色列受试者中巨细胞动脉炎(GCA)患者的癫痫发作风险,并与匹配的对照组进行比较:方法:纳入 2002 年至 2017 年期间确诊为 GCA 的患者。对照组根据性别、年龄、社会经济地位、出生国、糖尿病和高血压按 4:1 的比例进行匹配。研究期间之前有癫痫发作记录的患者被排除在外。癫痫发作的危险比通过 Cox 回归模型得出:研究队列由 8,103 名 GCA 患者和 32,412 名匹配对照组成。GCA 组中有 5535 名女性(占 68%),2644 名患者出生于以色列(占 33%),2888 名患者社会经济地位较低(占 36%)。该组患者的年龄中位数为 71 岁。GCA组和对照组的累计跟踪年数分别为54,641年和222,537年,GCA组每万人年中有15.92例,而对照组每万人年中只有9.62例。在未调整模型(HR = 1.66,95%CI [1.29-2.13])和调整模型(HR = 1.67,95%CI [1.3-2.14])中,GCA 与癫痫发作有关。在控制中风后,GCA 也与癫痫发作有关(HR = 1.55,95%CI [1.16-2.07]):根据这项研究,与普通人群相比,GCA 患者出现癫痫发作的风险更高。这种风险的增加与中风的易感性无关。一种可能的机制是 GCA 促炎状态可能会降低神经元去极化的阈值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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