Helena M Amar Muñoz, Juan Molina-Collada, Isabel Castrejón, Irene Monjo-Henry, Elisa Fernández-Fernández, José María Álvaro-Gracia, Eugenio de Miguel
{"title":"不同的巨细胞动脉炎表型可能呈现不同类型的缺血并发症。","authors":"Helena M Amar Muñoz, Juan Molina-Collada, Isabel Castrejón, Irene Monjo-Henry, Elisa Fernández-Fernández, José María Álvaro-Gracia, Eugenio de Miguel","doi":"10.55563/clinexprheumatol/kexxzi","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To determine if the subtype of vascular ultrasound (US) presentation is associated with different types of ischaemic complications (IC) in giant cell arteritis (GCA).</p><p><strong>Methods: </strong>Retrospective observational analysis of GCA clinically confirmed patients referred to US fast-track clinics at two centres. All patients underwent baseline US of cranial and extracranial arteries (carotid, subclavian and axillary). Two patterns of IC were analysed: the occurrence of acute anterior ischaemic optic neuropathy (AION) or the presence of a non-AION pattern (including stroke, acute coronary syndrome, pulmonary embolism or peripheral artery disease) at diagnosis and in the following 3 months, excluding other potentially implicated causes.</p><p><strong>Results: </strong>Of 188 clinically confirmed GCA patients, 43 (22.9%) had IC: 24 (12.8%) AION and 19 (10.1%) non-AION. Patients with AION more often exhibited US cranial involvement versus those with non-AION IC and without IC (100%, 63.2%, and 79.3%, respectively; p=0.009). Patients with AION less frequently presented signs of US large vessel (LV)-GCA than those with non-AION IC and without IC (25%, 63.2% and 55.2%, respectively; p=0.014). Patients with previous polymyalgia rheumatica (PMR) (p=0.049) or concomitant PMR symptoms at the time of diagnosis (p=0.014) showed less frequent AION. In contrast, patients with non-AION IC more frequently had positive LV-GCA US findings vs the other two groups (63.2%, 25% and 55.2%, respectively; p=0.014).</p><p><strong>Conclusions: </strong>The subtype of vascular US presentation influences the IC in GCA. US cranial-GCA patients more frequently present AION, while predominantly US LV-GCA more frequently exhibit non-AION IC.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Different giant cell arteritis phenotypes may present distinct types of ischaemic complications.\",\"authors\":\"Helena M Amar Muñoz, Juan Molina-Collada, Isabel Castrejón, Irene Monjo-Henry, Elisa Fernández-Fernández, José María Álvaro-Gracia, Eugenio de Miguel\",\"doi\":\"10.55563/clinexprheumatol/kexxzi\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To determine if the subtype of vascular ultrasound (US) presentation is associated with different types of ischaemic complications (IC) in giant cell arteritis (GCA).</p><p><strong>Methods: </strong>Retrospective observational analysis of GCA clinically confirmed patients referred to US fast-track clinics at two centres. All patients underwent baseline US of cranial and extracranial arteries (carotid, subclavian and axillary). Two patterns of IC were analysed: the occurrence of acute anterior ischaemic optic neuropathy (AION) or the presence of a non-AION pattern (including stroke, acute coronary syndrome, pulmonary embolism or peripheral artery disease) at diagnosis and in the following 3 months, excluding other potentially implicated causes.</p><p><strong>Results: </strong>Of 188 clinically confirmed GCA patients, 43 (22.9%) had IC: 24 (12.8%) AION and 19 (10.1%) non-AION. Patients with AION more often exhibited US cranial involvement versus those with non-AION IC and without IC (100%, 63.2%, and 79.3%, respectively; p=0.009). Patients with AION less frequently presented signs of US large vessel (LV)-GCA than those with non-AION IC and without IC (25%, 63.2% and 55.2%, respectively; p=0.014). Patients with previous polymyalgia rheumatica (PMR) (p=0.049) or concomitant PMR symptoms at the time of diagnosis (p=0.014) showed less frequent AION. In contrast, patients with non-AION IC more frequently had positive LV-GCA US findings vs the other two groups (63.2%, 25% and 55.2%, respectively; p=0.014).</p><p><strong>Conclusions: </strong>The subtype of vascular US presentation influences the IC in GCA. US cranial-GCA patients more frequently present AION, while predominantly US LV-GCA more frequently exhibit non-AION IC.</p>\",\"PeriodicalId\":10274,\"journal\":{\"name\":\"Clinical and experimental rheumatology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2024-12-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical and experimental rheumatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.55563/clinexprheumatol/kexxzi\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and experimental rheumatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.55563/clinexprheumatol/kexxzi","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
Different giant cell arteritis phenotypes may present distinct types of ischaemic complications.
Objectives: To determine if the subtype of vascular ultrasound (US) presentation is associated with different types of ischaemic complications (IC) in giant cell arteritis (GCA).
Methods: Retrospective observational analysis of GCA clinically confirmed patients referred to US fast-track clinics at two centres. All patients underwent baseline US of cranial and extracranial arteries (carotid, subclavian and axillary). Two patterns of IC were analysed: the occurrence of acute anterior ischaemic optic neuropathy (AION) or the presence of a non-AION pattern (including stroke, acute coronary syndrome, pulmonary embolism or peripheral artery disease) at diagnosis and in the following 3 months, excluding other potentially implicated causes.
Results: Of 188 clinically confirmed GCA patients, 43 (22.9%) had IC: 24 (12.8%) AION and 19 (10.1%) non-AION. Patients with AION more often exhibited US cranial involvement versus those with non-AION IC and without IC (100%, 63.2%, and 79.3%, respectively; p=0.009). Patients with AION less frequently presented signs of US large vessel (LV)-GCA than those with non-AION IC and without IC (25%, 63.2% and 55.2%, respectively; p=0.014). Patients with previous polymyalgia rheumatica (PMR) (p=0.049) or concomitant PMR symptoms at the time of diagnosis (p=0.014) showed less frequent AION. In contrast, patients with non-AION IC more frequently had positive LV-GCA US findings vs the other two groups (63.2%, 25% and 55.2%, respectively; p=0.014).
Conclusions: The subtype of vascular US presentation influences the IC in GCA. US cranial-GCA patients more frequently present AION, while predominantly US LV-GCA more frequently exhibit non-AION IC.
期刊介绍:
Clinical and Experimental Rheumatology is a bi-monthly international peer-reviewed journal which has been covering all clinical, experimental and translational aspects of musculoskeletal, arthritic and connective tissue diseases since 1983.