DEMOGRAPHIC AND CLINICAL FEATURES OF TAKAYASU ARTERITIS IN WEST AZERBAIJAN, IRAN: 2010-2018

Background:Hypertension occurred in 30-80% of TAK patients around the world. The occurrence of hypertension might severely worsen TAK prognosis. Nevertheless, data describing the specific imaging features in hypertensive TAK patients and the associations between hypertensive severity, blood pressure control status and long-term outcome were still lacking.Objectives:To investigate the characteristics and associations of hypertensive characteristics with adverse events-free survival in Takayasu arteritis (TAK) patients with hypertension.Methods:This research was based on a prospectively on-going observational cohort-East China Takayasu Arteritis (ECTA) cohort. In all, 618 TAK patients, who registered in the ECTA cohort up to December 2019, were enrolled. The main outcome was the adverse-events-free survival among hypertensive TAK patients during the follow-up ended on August 2020.Results:Totally, 204 (33.0%) patients suffered from hypertension, with 48 (23.5%), 62 (30.4%), and 94 (46.1%) mild, moderate, and severe hypertension, respectively. Cluster analysis indicated three imaging phenotypes for hypertensive TAK patients: Cluster 1: involvement of the abdominal aorta and/or renal artery (n=56, 27.5%); Cluster 2: involvement of the ascending aorta, thoracic aorta, and the aortic arch and its branches (n=38, 18.6%); Cluster 3: combined involvement of Cluster 1 and Cluster 2 (n=111, 54.4%). By the end of the follow-up, the blood pressure control rate was 50.8%, while the adverse-events-free survival was 67.9% in the entire hypertensive population. Multivariate Cox regression analysis indicated that well-controlled blood pressure (HR=2.13, 95%CI 1.32–3.78, p=0.047), co-existence of severe aortic valve regurgitation (HR=0.87, 95%CI 0.64–0.95, p=0.043), Cluster 1 (HR=0.69, 95%CI 0.48–0.92, p=0.017) and Cluster 3 (HR=0.72, 95%CI 0.43–0.94, p=0.048) imaging phenotype was associated with the adverse-events-free survival.Conclusion:Patients with controlled hypertension showed better adverse-events-free survival, while those with the Cluster 1 imaging phenotype were more likely to suffer from worse adverse-events-free survival. Hypertension occurred in 30-80% of TAK patients around the world. The occurrence of hypertension might severely worsen TAK prognosis.References:[1]Johnston SL, Lock RJ, Gompels MM. Takayasu arteritis: a review. J Clin Pathol 2002; 55:481–6.[2]Watanabe Y, Miyata T, Tanemoto K. Current clinical features of new patients with Takayasu arteritis observed from a cross-country research in Japan: age and sex specificity. Circulation 2015; 132:1701–9.[3]Yilmaz N, Can M, Oner FA, et al. Impaired quality of life, disability and mental health in Takayasu’s arteritis. Rheumatol. (Oxford) 2013; 52:1898–904.[4]Laurent A, Julien H, Nicolas L, et al. Takayasu arteritis in France: a single-center retrospective study of 82 cases comparing white, North African, and black patients. Medicine 2010; 89:1–17.[5]Mwipatayi BP, Jeffery PC, Beningfield SJ, et al. Takayasu arteritis: clinical features and management: report of 272 cases. ANZ J Surg 2005; 75:110–7.Disclosure of Interests:None declared

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146. ARE CHILDHOOD-ONSET AND ADULT-ONSET TAKAYASU ARTERITIS SIMILAR IN TERMS OF CLINICAL FEATURES AND DISEASE COURSE?

Rheumatology ◽

10.1093/rheumatology/kez059.023 ◽

2019 ◽

Vol 58 (Supplement_2) ◽

Author(s):

Ertugrul Cagri ◽

Bolek Selcan Demir ◽

Alper Sari ◽

Ummusen Kaya Akca ◽

Levent Kilic ◽

...

Keyword(s):

Clinical Features ◽

Takayasu Arteritis ◽

Disease Course ◽

Adult Onset ◽

Childhood Onset

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Current Clinical Features of New Patients With Takayasu Arteritis Observed From Cross-Country Research in Japan

Circulation ◽

10.1161/circulationaha.114.012547 ◽

2015 ◽

Vol 132 (18) ◽

pp. 1701-1709 ◽

Cited By ~ 74

Author(s):

Yoshiko Watanabe ◽

Tetsuro Miyata ◽

Kazuo Tanemoto

Keyword(s):

Clinical Features ◽

Takayasu Arteritis ◽

Cross Country

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Clinical Features and Risk Factors for Active Tuberculosis in Takayasu Arteritis: A Single-Center Case-Control Study

Frontiers in Immunology ◽

10.3389/fimmu.2021.749317 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jiawei Zhou ◽

Ruoyu Ji ◽

Rui Zhu ◽

Jingya Zhou ◽

Jing Li ◽

...

Keyword(s):

Risk Factors ◽

Weight Loss ◽

Logistic Regression ◽

Regression Analysis ◽

Clinical Features ◽

Takayasu Arteritis ◽

Multivariate Logistic Regression Analysis ◽

Active Tuberculosis ◽

Case Group ◽

Multivariate Logistic Regression

BackgroundsTakayasu arteritis (TAK) is a chronic, granulomatous vasculitis correlated with tuberculosis (TB). The two diseases share similar pathological characteristics and clinical manifestations which increase the difficulty to diagnose. Active tuberculosis (ATB) has implications for treatment strategies in TAK patients. Therefore, the investigation of clinical features and potential risk factors of ATB in TAK patients is vital.MethodsThe study reviewed hospitalized patients diagnosed with TAK in our hospital from 2008, to 2021. TAK patients with ATB were enrolled as the case group. The control group was randomly selected in a 3:1 ratio. The clinical characteristics of TAK patients with and without ATB were compared. Multivariate logistic regression analysis was performed to determine risk factors for ATB in TAK patients.ResultsWe reviewed 1,789 patients and ultimately identified 30 (1.7%) ATB cases. TAK patients with ATB were more prone to develop symptoms including fever (p=0.001), fatigue (p=0.003), cough (p=0.037), expectoration (p<0.001), weight loss (p=0.003), and night sweating (p<0.001). Increased level of hypersensitive C reactive protein (hsCRP, p=0.001), decreased level of albumin (p=0.031), and higher positive rate of T-SPOT.TB test (p<0.001) were observed in the case group. Multivariate logistic regression analysis revealed that hsCRP >8 mg/L (OR 9.108; 95% CI, 1.096–75.711; p=0.041) and positive T-SPOT.TB result (OR 68.669; 95% CI, 7.291–646.738; p<0.001) were risk factors for ATB in TAK patients. The proportion of patients undergoing subsequent surgery for Takayasu arteritis was lower in patients with ATB (p<0.001).ConclusionOur study suggested that the diagnosis of ATB should be considered when TAK patients experienced symptoms including fever, fatigue, weight loss, etc. hsCRP >8 mg/L and positive T-SPOT.TB result were identified as independent risk factors for ATB in TAK patients.

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Associations between clinical features and therapy with macrophage subpopulations and T cells in inflammatory lesions in the aorta from patients with Takayasu arteritis

Clinical & Experimental Immunology ◽

10.1111/cei.13489 ◽

2020 ◽

Vol 202 (3) ◽

pp. 384-393

Author(s):

J. P. Santos ◽

R. Artigiani Neto ◽

C. L. P. Mangueira ◽

R. Z. Filippi ◽

P. S. Gutierrez ◽

...

Keyword(s):

T Cells ◽

Clinical Features ◽

Takayasu Arteritis ◽

Inflammatory Lesions ◽

Macrophage Subpopulations

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Takayasu arteritis: a cohort of Italian patients and recent pathogenetic and therapeutic advances

Clinical and Experimental Medicine ◽

10.1007/s10238-020-00668-7 ◽

2020 ◽

Author(s):

Franco Dammacco ◽

Anna Cirulli ◽

Annalisa Simeone ◽

Patrizia Leone ◽

Raffaele Pulli ◽

...

Keyword(s):

Clinical Features ◽

Takayasu Arteritis ◽

Imaging Techniques ◽

Immunosuppressive Agents ◽

Disease Onset ◽

Response To Therapy ◽

Disease Classification ◽

Vascular Involvement ◽

Unknown Etiology ◽

Biologic Drugs

Abstract Takayasu arteritis (TAK) is a rare granulomatous vasculitis of unknown etiology that mainly affects the aorta and its major branches. The aim is to describe the clinical features, diagnostic procedures, pathogenesis, and management of TAK in a longitudinal cohort of patients recruited within a single region of southern Italy. The cohort included 43 patients who were diagnosed with TAK and followed up according to a standard protocol, in a collaboration between four university tertiary referral centers and a regional hospital. Clinical and imaging classification criteria were those established by the American College of Rheumatology. Thirty-five patients (81.4%) were female, and the mean age at disease onset was 32.6 (range 16–54) years. Angiographic assessment of the vascular involvement allowed disease classification in five different types. Clinical features ranged from constitutional symptoms in the early inflammatory stage of the disease to cardiovascular ischemic symptoms in the late, chronic stage. Noninvasive imaging techniques were employed to assess the extent and severity of the arterial wall damage and to monitor the clinical course and response to therapy. Medical treatment, based on pathogenetic insights into the roles of humoral and cell-mediated immune mechanisms, included glucocorticoids mostly combined with steroid-sparing immunosuppressive agents and, in patients with relapsing/refractory disease, biologic drugs. Significant clinical and angiographic differences have been detected in TAK patients from different geographic areas. Patients with life-threatening cardiovascular and neurologic manifestations as well as sight-threatening ophthalmologic signs and symptoms should be promptly diagnosed, properly treated, and closely followed up to avoid potentially severe consequences.

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