Cardiovascular and Renal Morbidity in Takayasu Arteritis: A Population-Based Retrospective Cohort Study From the United Kingdom

Ruchika Goel; Joht Singh Chandan; Rasiah Thayakaran; Nicola J Adderley; Krishnarajah Nirantharakumar; Lorraine Harper

doi:10.1002/art.41529

Cardiovascular and Renal Morbidity in Takayasu Arteritis: A Population-Based Retrospective Cohort Study From the United Kingdom

Ruchika Goel
, Joht Singh Chandan
, Rasiah Thayakaran
, Nicola J Adderley
, Krishnarajah Nirantharakumar^*
, Lorraine Harper^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVE: Cardiovascular disease (CVD) is a major complication and cause of mortality in Takayasu arteritis (TAK), but population-based controlled studies from the UK are lacking. We undertook the present study to investigate the frequency of morbidity and mortality related to CVD, as well as to cerebrovascular and kidney disease, among patients with TAK in the UK.

METHODS: Yearly cohort and cross-sectional studies were performed from 2000 to 2017 to estimate annual incidence and prevalence, respectively, of TAK. Using a UK primary care database (IQVIA Medical Research Data), an open retrospective matched cohort study was conducted to estimate risk of hypertension, diabetes, cardiovascular morbidity, chronic kidney disease (CKD), and all-cause mortality in TAK. Risk (adjusted hazard ratio [HR]) of the assessed comorbidities among patients with TAK compared to age- and sex-matched controls was estimated. Changes in medication prescription over time were examined in both groups.

RESULTS: One hundred forty-two patients with TAK (median age 53.4 years [interquartile range 33.8-70.7]) and 1,371 matched controls were included. The annual incidence and prevalence of TAK were 0.8 per million and 7.5 per million respectively. All-cause mortality was increased in TAK (adjusted HR 1.88 [95% confidence interval 1.29-2.76]). Patients with TAK had an increased risk of developing ischemic heart disease, stroke/transient ischemic attack, combined CVD, and peripheral vascular disease compared to controls, but no increase in risk of hypertension, CKD, heart failure, or diabetes. Only ~50% of patients with TAK requiring secondary CVD prevention were prescribed statins or antiplatelet agents within 1 year after study entry.

CONCLUSION: Cardiovascular morbidity was increased among patients with TAK receiving primary care services in the UK. Treatment with statins and antiplatelet agents in these patients was suboptimal.

Original language	English
Pages (from-to)	504-511
Number of pages	8
Journal	Arthritis and Rheumatology
Volume	73
Issue number	3
Early online date	22 Jan 2021
DOIs	https://doi.org/10.1002/art.41529
Publication status	Published - 26 Feb 2021

Bibliographical note

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Adolescent
Adult
Aged
Cardiovascular Diseases/drug therapy
Cause of Death
Cohort Studies
Diabetes Mellitus/epidemiology
Female
Glucocorticoids/therapeutic use
Heart Failure/drug therapy
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use
Hypertension/drug therapy
Immunosuppressive Agents/therapeutic use
Ischemic Attack, Transient/drug therapy
Male
Middle Aged
Mortality
Myocardial Ischemia/drug therapy
Peripheral Vascular Diseases/drug therapy
Platelet Aggregation Inhibitors/therapeutic use
Proportional Hazards Models
Renal Insufficiency, Chronic/epidemiology
Retrospective Studies
Risk
Secondary Prevention
Stroke/drug therapy
Takayasu Arteritis/drug therapy
United Kingdom/epidemiology
Young Adult

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10.1002/art.41529Licence: None: All rights reserved

Cite this

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title = "Cardiovascular and Renal Morbidity in Takayasu Arteritis: A Population-Based Retrospective Cohort Study From the United Kingdom",

abstract = "OBJECTIVE: Cardiovascular disease (CVD) is a major complication and cause of mortality in Takayasu arteritis (TAK), but population-based controlled studies from the UK are lacking. We undertook the present study to investigate the frequency of morbidity and mortality related to CVD, as well as to cerebrovascular and kidney disease, among patients with TAK in the UK.METHODS: Yearly cohort and cross-sectional studies were performed from 2000 to 2017 to estimate annual incidence and prevalence, respectively, of TAK. Using a UK primary care database (IQVIA Medical Research Data), an open retrospective matched cohort study was conducted to estimate risk of hypertension, diabetes, cardiovascular morbidity, chronic kidney disease (CKD), and all-cause mortality in TAK. Risk (adjusted hazard ratio [HR]) of the assessed comorbidities among patients with TAK compared to age- and sex-matched controls was estimated. Changes in medication prescription over time were examined in both groups.RESULTS: One hundred forty-two patients with TAK (median age 53.4 years [interquartile range 33.8-70.7]) and 1,371 matched controls were included. The annual incidence and prevalence of TAK were 0.8 per million and 7.5 per million respectively. All-cause mortality was increased in TAK (adjusted HR 1.88 [95\% confidence interval 1.29-2.76]). Patients with TAK had an increased risk of developing ischemic heart disease, stroke/transient ischemic attack, combined CVD, and peripheral vascular disease compared to controls, but no increase in risk of hypertension, CKD, heart failure, or diabetes. Only \textasciitilde{}50\% of patients with TAK requiring secondary CVD prevention were prescribed statins or antiplatelet agents within 1 year after study entry.CONCLUSION: Cardiovascular morbidity was increased among patients with TAK receiving primary care services in the UK. Treatment with statins and antiplatelet agents in these patients was suboptimal.",

keywords = "Adolescent, Adult, Aged, Cardiovascular Diseases/drug therapy, Cause of Death, Cohort Studies, Diabetes Mellitus/epidemiology, Female, Glucocorticoids/therapeutic use, Heart Failure/drug therapy, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use, Hypertension/drug therapy, Immunosuppressive Agents/therapeutic use, Ischemic Attack, Transient/drug therapy, Male, Middle Aged, Mortality, Myocardial Ischemia/drug therapy, Peripheral Vascular Diseases/drug therapy, Platelet Aggregation Inhibitors/therapeutic use, Proportional Hazards Models, Renal Insufficiency, Chronic/epidemiology, Retrospective Studies, Risk, Secondary Prevention, Stroke/drug therapy, Takayasu Arteritis/drug therapy, United Kingdom/epidemiology, Young Adult",

author = "Ruchika Goel and Chandan, \{Joht Singh\} and Rasiah Thayakaran and Adderley, \{Nicola J\} and Krishnarajah Nirantharakumar and Lorraine Harper",

note = "{\textcopyright} 2020, American College of Rheumatology.",

year = "2021",

month = feb,

day = "26",

doi = "10.1002/art.41529",

language = "English",

volume = "73",

pages = "504--511",

journal = "Arthritis and Rheumatology",

issn = "2326-5191",

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T1 - Cardiovascular and Renal Morbidity in Takayasu Arteritis

T2 - A Population-Based Retrospective Cohort Study From the United Kingdom

AU - Goel, Ruchika

AU - Chandan, Joht Singh

AU - Thayakaran, Rasiah

AU - Adderley, Nicola J

AU - Nirantharakumar, Krishnarajah

AU - Harper, Lorraine

PY - 2021/2/26

Y1 - 2021/2/26

N2 - OBJECTIVE: Cardiovascular disease (CVD) is a major complication and cause of mortality in Takayasu arteritis (TAK), but population-based controlled studies from the UK are lacking. We undertook the present study to investigate the frequency of morbidity and mortality related to CVD, as well as to cerebrovascular and kidney disease, among patients with TAK in the UK.METHODS: Yearly cohort and cross-sectional studies were performed from 2000 to 2017 to estimate annual incidence and prevalence, respectively, of TAK. Using a UK primary care database (IQVIA Medical Research Data), an open retrospective matched cohort study was conducted to estimate risk of hypertension, diabetes, cardiovascular morbidity, chronic kidney disease (CKD), and all-cause mortality in TAK. Risk (adjusted hazard ratio [HR]) of the assessed comorbidities among patients with TAK compared to age- and sex-matched controls was estimated. Changes in medication prescription over time were examined in both groups.RESULTS: One hundred forty-two patients with TAK (median age 53.4 years [interquartile range 33.8-70.7]) and 1,371 matched controls were included. The annual incidence and prevalence of TAK were 0.8 per million and 7.5 per million respectively. All-cause mortality was increased in TAK (adjusted HR 1.88 [95% confidence interval 1.29-2.76]). Patients with TAK had an increased risk of developing ischemic heart disease, stroke/transient ischemic attack, combined CVD, and peripheral vascular disease compared to controls, but no increase in risk of hypertension, CKD, heart failure, or diabetes. Only ~50% of patients with TAK requiring secondary CVD prevention were prescribed statins or antiplatelet agents within 1 year after study entry.CONCLUSION: Cardiovascular morbidity was increased among patients with TAK receiving primary care services in the UK. Treatment with statins and antiplatelet agents in these patients was suboptimal.

AB - OBJECTIVE: Cardiovascular disease (CVD) is a major complication and cause of mortality in Takayasu arteritis (TAK), but population-based controlled studies from the UK are lacking. We undertook the present study to investigate the frequency of morbidity and mortality related to CVD, as well as to cerebrovascular and kidney disease, among patients with TAK in the UK.METHODS: Yearly cohort and cross-sectional studies were performed from 2000 to 2017 to estimate annual incidence and prevalence, respectively, of TAK. Using a UK primary care database (IQVIA Medical Research Data), an open retrospective matched cohort study was conducted to estimate risk of hypertension, diabetes, cardiovascular morbidity, chronic kidney disease (CKD), and all-cause mortality in TAK. Risk (adjusted hazard ratio [HR]) of the assessed comorbidities among patients with TAK compared to age- and sex-matched controls was estimated. Changes in medication prescription over time were examined in both groups.RESULTS: One hundred forty-two patients with TAK (median age 53.4 years [interquartile range 33.8-70.7]) and 1,371 matched controls were included. The annual incidence and prevalence of TAK were 0.8 per million and 7.5 per million respectively. All-cause mortality was increased in TAK (adjusted HR 1.88 [95% confidence interval 1.29-2.76]). Patients with TAK had an increased risk of developing ischemic heart disease, stroke/transient ischemic attack, combined CVD, and peripheral vascular disease compared to controls, but no increase in risk of hypertension, CKD, heart failure, or diabetes. Only ~50% of patients with TAK requiring secondary CVD prevention were prescribed statins or antiplatelet agents within 1 year after study entry.CONCLUSION: Cardiovascular morbidity was increased among patients with TAK receiving primary care services in the UK. Treatment with statins and antiplatelet agents in these patients was suboptimal.

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KW - Diabetes Mellitus/epidemiology

KW - Female

KW - Glucocorticoids/therapeutic use

KW - Heart Failure/drug therapy

KW - Humans

KW - Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use

KW - Hypertension/drug therapy

KW - Immunosuppressive Agents/therapeutic use

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KW - Mortality

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KW - Peripheral Vascular Diseases/drug therapy

KW - Platelet Aggregation Inhibitors/therapeutic use

KW - Proportional Hazards Models

KW - Renal Insufficiency, Chronic/epidemiology

KW - Retrospective Studies

KW - Risk

KW - Secondary Prevention

KW - Stroke/drug therapy

KW - Takayasu Arteritis/drug therapy

KW - United Kingdom/epidemiology

KW - Young Adult

U2 - 10.1002/art.41529

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M3 - Article

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JO - Arthritis and Rheumatology

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ER -

Cardiovascular and Renal Morbidity in Takayasu Arteritis: A Population-Based Retrospective Cohort Study From the United Kingdom

Abstract

Bibliographical note

UN SDGs

Keywords

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