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Deprecated: Implicit conversion from float 278.79999999999995 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Mayo+Clin+Proc 2018 ; 93 (5): 597-606 Nephropedia Template TP
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Risk of Cardiovascular Disease and Venous Thromboembolism Among Patients With Incident ANCA-Associated Vasculitis: A 20 year Population-Based Cohort Study #MMPMID29588079
Berti A; Matteson EL; Crowson CS; Specks U; Cornec D
Mayo Clin Proc 2018[May]; 93 (5): 597-606 PMID29588079show ga
Objectives: To assess the cardiovascular disease (CVD) and venous thromboembolism (VTE) risks among patients with newly diagnosed ANCA-associated vasculitis (AAV). Patients and Methods: A population-based incident AAV cohort of 58 patients diagnosed between 1996 and 2015 in Olmsted County (Minnesota, USA) was identified by medical record review. For each patient, 3 age- and sex-matched non-AAV comparators were randomly selected from the same population and assigned an index date corresponding to the AAV incidence date. Medical records of cases and comparators were reviewed for CVD events, which included cardiac events (coronary artery disease, heart failure and atrial fibrillation), cerebrovascular accidents (CVA), peripheral vascular disease (PVD) and VTE, which included deep vein thrombosis (DVT) and pulmonary embolism (PE). Results: Baseline total cholesterol, high-density lipoprotein and current smoking rate were lower in AAV than comparators (P=.03, P=.01 and P=.04, respectively), while other CVD risk factors and Framingham risk score were not significantly different between the 2 groups. CVD events developed in 13 patients and 17 comparators, corresponding to a >3 fold increased risk (hazard ratio [HR] 3.15; 95% confidence interval [CI]:1.51-6.57). By subtypes, risks were increased for cardiac events (HR 2.96, 95%CI:1.42-6.15) and CVA (HR 8.16, 95%CI:2.45-27.15), but not for PVD. The HR for VTE was 3.26 (95%CI: 0.84-12.60), significantly increased for DVT (HR 6.25, 95%CI:1.16-33.60), but not for PE (HR 1.33, 95%CI:0.23-7.54). Conclusions: Despite a similar prevalence of CVD risk factors at baseline, the risk of CVD is >3 fold higher and for CVA 8-fold higher in patients with incident AAV than matched comparator subjects.