Prevalence and impact of cerebrovascular risk factors in patients with giant cell arteritis: An observational study from the Spanish national registry

Abstract

Objective

To assess the prevalence and impact of cerebrovascular risk factors (CRF) on cerebrovascular events (CVE) in patients with giant cell arteritis (GCA).

Methods

Analysis of the patients diagnosed with GCA identified in the Spanish Hospital Discharge Database between 2016 and 2018.

Results

8,474 hospital admissions from patients diagnosed with GCA were identified. 3.4% of the admissions were motivated by CVE (stroke in 2.8% and transient ischemic attack in 0.6%). When compared with the admissions due to other causes, the patients who suffered from CVE presented a higher rate of male sex (36.2% vs 43.5%, p = 0.007), hypertension (66.9% vs 74.4%, p = 0.004), diabetes (27.6% vs 33.7%, p = 0.016) and atherosclerosis (6.6% vs 10.2%, p = 0.0.017). After adjustment, male sex (OR = 1.35, 95% CI 1.06–1.72) and mainly hypertension (OR = 1.44, 95% CI 1.11–1.90) were associated with a higher risk of CVE.

Conclusion

Hypertension, along with male sex, was the strongest risk factor for cerebrovascular events in GCA patients. In these high-risk patients, antiplatelet therapy should be re-considered and evaluated in prospective studies.

Resumen

Objetivo

Evaluar la prevalencia e impacto de los factores de riesgo cerebrovasculares en los episodios cerebrovasculares (ECV) de pacientes con arteritis de células gigantes (ACG).

Métodos

Análisis de los pacientes diagnosticados con ACG identificados en la base de altas hospitalarias española entre 2016 y 2018.

Resultados

Se identificaron 8.474 ingresos hospitalarios en pacientes diagnosticados de ACG. El 3,4% de los ingresos se atribuyó a ECV (ictus en 2,8% y accidente isquémico transitorio en 0,6%). En comparación con los ingresos por otras causas, los pacientes que presentaron ECV mostraron una mayor tasa de sexo masculino (36,2 frente a 43,5%, p = 0,007), hipertensión (66,9 frente a 74,4%, p = 0,004), diabetes (27,6 frente a 33,7%, p = 0,016) y aterosclerosis (6,6 frente a 10,2%, p = 0,0017). Tras el ajuste, el sexo masculino (OR = 1,35, IC 95% 1,06-1,72) y principalmente la hipertensión (OR = 1,44, IC 95% 1,11-1,90) se asociaron con un mayor riesgo de ECV.

Conclusión

La hipertensión, junto con el sexo masculino, fueron los principales factores de riesgo de ECV en los pacientes con ACG. En estos pacientes de alto riesgo, el tratamiento con antiagregantes debería reconsiderarse y evaluarse en estudios prospectivos.