Biomaterial Database

Long-Term Outcomes and Prognostic Factors of Complications in Takayasu Arteritis: A Multicenter Study of 318 Patients. 2017

Cloé Comarmond, and Lucie Biard, and Marc Lambert, and Arsène Mekinian, and Yasmina Ferfar, and Jean-Emmanuel Kahn, and Ygal Benhamou, and Laurent Chiche, and Fabien Koskas, and Philippe Cluzel, and Eric Hachulla, and Emmanuel Messas, and Matthieu Resche-Rigon, and Patrice Cacoub, and Tristan Mirault, and David Saadoun, and

From Sorbonne Universités, UPMC Univ Paris 06, Inflammation-Immunopathology-Biotherapy Department, France (C.C., P.C, D.S.); INSERM, Paris, France (C.C., P.C, D.S.); Centre National de la Recherche Scientifique, Paris, France (C.C., P.C, D.S.); AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, Centre de Référence des Maladies Auto-Immunes et Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires, Paris, France (C.C., Y.F., P.C, D.S.); AP-HP, SBIM, Hôpital Saint-Louis, Université Paris Diderot, France (L.B., M.R.-R.); INSERM, ECSTRA Team, Paris, France (L.B., M.R.-R.); Hôpital Claude Huriez, Service de Médecine Interne, Centre de Référence des Maladies Auto-Immunes et Systémiques Rares, CHRU, Université de Lille, France (M.L., E.H.); AP-HP, Service de Médecine Interne, Hôpital Saint-Antoine, UPMC, Paris France (A.M.); Service de Médecine Interne, Hôpital Foch, Suresnes, France (J.-E.K.); Service de Médecine Interne, CHU de Rouen, France (Y.B.); AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Chirurgie Vasculaire, UPMC, Paris, France (L.C., F.K.); AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département d'Imagerie CardioVasculaire et de Radiologie Interventionnelle, UPMC, INSERM-Centre National de la Recherche Scientifique-LIB, Paris, France (P.C.); AP-HP, Hôpital Européen Georges-Pompidou, Service de Médecine Vasculaire, INSERM UMR970, PARCC, Centre de Référence des Maladies Vasculaires Rares, DHU Pathologies Artérielles Rares et Communes, Hôpitaux Universitaires Paris Ouest, Université Paris Descartes, Sorbonne Paris Cité, France (E.M., T.M.).

BACKGROUND Because of the wide variation in the course of Takayasu arteritis (TA), predicting outcome is challenging. We assess long-term outcome and prognosis factors for vascular complications in patients with TA. METHODS A retrospective multicenter study of characteristics and outcomes of 318 patients with TA fulfilling American College of Rheumatology and Ishikawa criteria was analyzed. Factors associated with event-free survival, relapse-free survival, and incidences of vascular complications were assessed. Risk factors for vascular complications were identified in a multivariable model. RESULTS The median age at TA diagnosis was 36 [25-47] years, and 276 patients (86.8%) were women. After a median follow-up of 6.1 years, relapses were observed in 43%, vascular complications in 38%, and death in 5%. Progressive clinical course was observed in 45%, carotidodynia in 10%, and retinopathy in 4%. The 5- and 10-year event-free survival, relapse-free survival, and complication-free survival were 48.2% (42.2; 54.9) and 36.4% (30.3; 43.9), 58.6% (52.7; 65.1) and 47.7% (41.2; 55.1), and 69.9% (64.3; 76.0) and 53.7% (46.8; 61.7), respectively. Progressive disease course (P=0.018) and carotidynia (P=0.036) were independently associated with event-free survival. Male sex (P=0.048), elevated C-reactive protein (P=0.013), and carotidynia (P=0.003) were associated with relapse-free survival. Progressive disease course (P=0.017), thoracic aorta involvement (P=0.009), and retinopathy (P=0.002) were associated with complication-free survival. CONCLUSIONS This nationwide study shows that 50% of patients with TA will relapse and experience a vascular complication ≤10 years from diagnosis. We identified specific characteristics that identified those at highest risk for subsequent vascular complications.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D011379	Prognosis	A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.	Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D002097	C-Reactive Protein	A plasma protein that circulates in increased amounts during inflammation and after tissue damage. C-Reactive Protein measured by more sensitive methods often for coronary heart disease risk assessment is referred to as High Sensitivity C-Reactive Protein (hs-CRP).	High Sensitivity C-Reactive Protein,hs-CRP,hsCRP,C Reactive Protein,High Sensitivity C Reactive Protein
D002318	Cardiovascular Diseases	Pathological conditions involving the CARDIOVASCULAR SYSTEM including the HEART; the BLOOD VESSELS; or the PERICARDIUM.	Adverse Cardiac Event,Cardiac Events,Major Adverse Cardiac Events,Adverse Cardiac Events,Cardiac Event,Cardiac Event, Adverse,Cardiac Events, Adverse,Cardiovascular Disease,Disease, Cardiovascular,Event, Cardiac
D002648	Child	A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL.	Children
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293	Adolescent	A person 13 to 18 years of age.	Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328	Adult	A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available.	Adults