scholarly journals The effect of late diagnosis on survival and risk of vascular complications in Takayasu's arteritis patients

2021 ◽  
Vol 59 (6) ◽  
pp. 720-726
Author(s):  
I. E. Borodina ◽  
A. A. Popov ◽  
L. A. Shardina
Keyword(s):  
Takayasu’S Arteritis ◽  
Vascular Complications ◽  
Premature Death ◽  
Cardiovascular Complications ◽  
Late Diagnosis ◽  
Takayasu's Arteritis ◽  
Delayed Treatment ◽  
Increased Risk ◽  
Ischemic Attack

Aim. To assess the effect of late diagnosis on survival and risk of vascular complications in Takayasu's arteritis (TA) patients.  Methods. 183 patients with TA who were treated at the Sverdlovsk Regional Clinical Hospital No. 1 during the period from 01.01.1979 to 31.04.2018 were examined. There were 139 women and 44 men included, median age at the time of diagnosis being 35 [24; 44] years in females and 34 [26.5; 42] years in males and a median interval from the first symptoms onset to the diagnosis of 3 [1; 7] and 4 [1.5; 8] years respectively. The diagnosis of TA met the ACR criteria (1990).Results. During the follow-up period, 31 deaths were observed (18 in males and 13 in females). The median age of death for women was 36 [32-44] years, for men - 50 [40-57] years. Cardiovascular complications were recorded in 72 patients (27 men and 45 women). Vascular complications and namely acute cerebrovascular accident observed in 31 (43%) patients, including ischemic stroke in 24 (35%), transient ischemic attack in 3 (3%) and hemorrhagic stroke in 4 (6%) were the most frequent. Arterial thromboses were registered in 32 (44%) cases. In 162 (88.5%) patients, the diagnosis was established more than six months after the appearance of the first symptoms.At the primary physician visit in 71 (39%) patients, the initial diagnosis was erroneous. The most common symptoms they had were regarded as a manifestation of arterial hypertension (in 18% cases). 4 years or more interval from the onset of TA symptoms to diagnosis was associated with a significant cardiovascular events odds increase (OR=1.8; 95% CI: 1.07-3.34) and premature death by the 5th year of follow-up (OR=2.9; 95% CI: 1,27-6,55).Conclusion. In the retrospective TA cohort setting, late diagnosis verification and delayed treatment initiation were associated with an increased risk of premature death and severe vascular complications, described earlier in other samplings. Timely diagnosis and as early as possible appropriate treatment administration can prevent the disease progression and disabling complications occurrence.

Long-Term Clinical Follow-up in A Case of Takayasu's Arteritis Involving the Ostium of Left Coronary Artery after Ostioplasty

2001 ◽  
Vol 31 (2) ◽  
pp. 246 ◽  
Author(s):  
Kyung Tae Kang ◽  
Myung Ho Jeong ◽  
Woo Kon Jeong ◽  
Sang Hyun Lee ◽  
Jay Young Rhew ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Left Coronary Artery ◽  
Takayasu’S Arteritis ◽  
Takayasu's Arteritis

Clinical features and survival in Takayasu’s arteritis-associated pulmonary hypertension: a nationwide study

2021 ◽  
Author(s):  
Xin Jiang ◽  
Yong-Jian Zhu ◽  
Yu-Ping Zhou ◽  
Fu-Hua Peng ◽  
Lan Wang ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Takayasu’S Arteritis ◽  
Survival Rates ◽  
Right Atrial ◽  
Takayasu's Arteritis ◽  
Functional Impairments ◽  
Term Survival ◽  
Increased Risk ◽  
Nationally Representative ◽  
Predominantly Female

Abstract Aims  This study aimed to assess the clinical characteristics and long-term survival outcome in patients with Takayasu’s arteritis-associated pulmonary hypertension (TA-PH). Methods and results We conducted a nationally representative cohort study of TA-PH using data from the National Rare Diseases Registry System of China. Patients with pulmonary artery involvement who fulfilled the diagnostic criteria of Takayasu’s arteritis and pulmonary hypertension were included. The primary outcome was the time from diagnosis of TA-PH to the occurrence of all-cause death. Between January 2007 and January 2019, a total of 140 patients were included, with a mean age of 41.4 years at diagnosis, and a female predominance (81%). Patients with TA-PH had severely haemodynamic and functional impairments at diagnosis. Significant improvements have been found in N-terminal pro-B-type natriuretic peptide (NT-proBNP) and haemodynamic profiles in patients with TA-PH receiving drugs approved for pulmonary arterial hypertension. The overall 1-, 3-, and 5-year survival rates in TA-PH were 94.0%, 83.2%, and 77.2%, respectively. Predictors associated with an increased risk of all-cause death were syncope [adjusted hazard ratio (HR) 5.38 (95% confidence interval 1.77–16.34), P = 0.003], NT-proBNP level [adjusted HR 1.04 (1.03–1.06), P < 0.001], and mean right atrial pressure [adjusted HR 1.07 (1.01–1.13), P = 0.015]. Conclusion  Patients with TA-PH were predominantly female and had severely compromised haemodynamics. More than 80% of patients in our cohort survived for at least 3 years. Medical treatment was based on investigators’ personal opinions, and no clear risk-to-benefit ratio can be derived from the presented data.

Ultrasonographic Study and Long-term Follow-up of Takayasu's Arteritis

Stroke ◽  
1996 ◽  
Vol 27 (12) ◽  
pp. 2178-2182 ◽  
Author(s):  
Yu Sun ◽  
Ping-Keung Yip ◽  
Jiann-Shing Jeng ◽  
Bao-Show Hwang ◽  
Win-Hwan Lin
Keyword(s):  
Takayasu’S Arteritis ◽  
Takayasu's Arteritis ◽  
Long Term Follow Up

scholarly journals Antibodies against Malondialdehyde in Haemodialysis Patients and Its Association with Clinical Outcomes: Differences between Subclasses and Isotypes

2020 ◽  
Vol 9 (3) ◽  
pp. 753
Author(s):  
Shailesh Kumar Samal ◽  
Abdul Rashid Qureshi ◽  
Mizanur Rahman ◽  
Peter Stenvinkel ◽  
Johan Frostegård
Keyword(s):  
Significant Risk ◽  
Premature Death ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Multivariate Risk ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Low Levels ◽  
Antibody Levels

Patients on haemodialysis (HD-patients) have an increased risk of premature death. Low levels of IgM antibodies against malondialdehyde (anti-MDA) are associated with increased risk of cardiovascular disease (CVD) with underlying potential mechanisms described. Here, we studied subclasses and isotypes of anti-MDA in 210 HD-patients with mortality as outcome (56% men, median age 66, Interquartile range (IQR) 51–74 years, vintage time 29 (15–58) months, mean follow up period of 41 (20–60)months). Patients were also divided into inflamed c-reactive protein (CRP >5.6 mg/mL) and non-inflamed. Antibody levels were measured by ELISA. In multivariate risk analysis, patients in low tertile of IgM anti-MDA sub-distribution hazard ratio (sHR 0.54); 95% confidence interval (CI: 0.34–0.89) inversely and significantly associated with all-cause mortality after five years, after adjusting for confounders. Low tertile of IgG (sHR 0.48, 95%CI: 0.25–0.90, p = 0.02) and IgG1 (sHR 0.50, CI: 0.24–1.04, p = 0.06) was associated low mortality among non-inflamed patients. In contrast, anti-MDA IgG2 among inflamed patients was significantly associated with increased mortality, IgG2(sHR 2.33, CI: 1.16–4.68, p = 0.01). IgM anti-MDA was a novel biomarker among HD-patients with low levels being associated with mortality, while low levels of IgG and IgG1 but not IgA anti-MDA were associated with mortality only among non-inflamed patients. IgG2 anti-MDA was a significant risk marker among inflamed patients, which could be related to infection.

scholarly journals Eight-year follow-up of endovascular repair of a brachiocephalic trunk aneurysm due to Takayasu's arteritis

2012 ◽  
Vol 56 (2) ◽  
pp. 504-507 ◽  
Author(s):  
Domenico Angiletta ◽  
Davide Marinazzo ◽  
Gloria Guido ◽  
Martinella Fullone ◽  
Raffaele Pulli ◽  
...  
Keyword(s):  
Endovascular Repair ◽  
Takayasu’S Arteritis ◽  
Takayasu's Arteritis ◽  
Brachiocephalic Trunk

Hybrid Endovascular Surgical Repair in Takayasu's Arteritis: Duplex Ultrasound Follow-up

2009 ◽  
Vol 33 (2) ◽  
pp. 80-87
Author(s):  
Karen Broadbent ◽  
Zsolt Garami ◽  
Eric K. Peden ◽  
Alan Lumsden
Keyword(s):  
Surgical Repair ◽  
Takayasu’S Arteritis ◽  
Duplex Ultrasound ◽  
Takayasu's Arteritis

Echocardiographic Follow-Up of Patients with Takayasu's Arteritis: Five-Year Survival

2006 ◽  
Vol 23 (5) ◽  
pp. 353-360 ◽  
Author(s):  
Maria Elena Soto ◽  
Nilda Espinola-Zavaleta ◽  
Oscar Ramirez-Quito ◽  
Pedro A. Reyes
Keyword(s):  
Takayasu’S Arteritis ◽  
Takayasu's Arteritis

The limited role of MRI in long-term follow-up of patients with Takayasu's arteritis

2011 ◽  
Vol 11 (2) ◽  
pp. 132-136 ◽  
Author(s):  
Yael Eshet ◽  
Rachel Pauzner ◽  
Orly Goitein ◽  
Pnina Langevitz ◽  
Iris Eshed ◽  
...  
Keyword(s):  
Takayasu’S Arteritis ◽  
Takayasu's Arteritis ◽  
Limited Role ◽  
Long Term Follow Up

scholarly journals Sortilin levels correlate with major cardiovascular events of diabetic patients with peripheral artery disease following revascularization: a prospective study

2020 ◽  
Author(s):  
Federico Biscetti ◽  
Elisabetta Nardella ◽  
Maria Margherita Rando ◽  
Andrea Leonardo Cecchini ◽  
Nicola Bonadia ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Cardiovascular Events ◽  
Vascular Complications ◽  
Diabetic Patients ◽  
Operating Characteristics ◽  
Peripheral Artery ◽  
Baseline Serum ◽  
Increased Risk ◽  
Artery Disease

Abstract Background: Peripheral artery disease (PAD) represents one of the most relevant vascular complications of type 2 diabetes mellitus (T2DM). Moreover, T2DM patients suffering from PAD have an increased risk of major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Sortilin, a protein involved in apolipoproteins trafficking, is associated with lower limb PAD in T2DM patients.Objective: To evaluate the relationship between baseline serum levels of sortilin, MACE and MALE occurrence after revascularization of T2DM patients with PAD and chronic limb-threatening ischemia (CLTI).Research Design and Methods: We performed a prospective non-randomized study including 230 statin-free T2DM patients with PAD and CLTI. Sortilin levels were measured before the endovascular intervention and incident outcomes were assessed during a 12-month follow-up.Results: Sortilin levels were significantly increased in individuals with more aggressive PAD (2.25 ± 0.51 ng/mL vs 1.44 ± 0.47 ng/mL, p < 0.001). During follow-up, 83 MACE and 116 MALE occurred. In patients, who then developed MACE and MALE, sortilin was higher. In particular, 2.46 ± 0.53 ng/mL vs 1.55 ± 0.42 ng/mL, p < 0.001 for MACE and 2.10 ± 0.54 ng/mL vs 1.65 ± 0.65 ng/mL, p < 0.001 for MALE. After adjusting for traditional atherosclerosis risk factors, the association between sortilin and vascular outcomes remained significant in a multivariate analysis. In our receiver operating characteristics (ROC) curve analysis using sortilin levels the prediction of MACE incidence improved (area under the curve [AUC] = 0.94) and MALE (AUC = 0.72).Conclusions: This study demonstrates that sortilin correlates with incidence of MACE and MALE after endovascular revascularization in a diabetic population with PAD and CLTI.

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