Derivation of an angiographically based classification system in Takayasu's arteritis: An observational study from India and North America

Ruchika Goel, K. Bates Gribbons, Simon Carette, David Cuthbertson, Gary S. Hoffman, George Joseph, Nader A. Khalidi, Curry L. Koening, Sathish Kumar, Carol Langford, Kathleen Maksimowicz-Mckinnon, Carol A. McAlear, Paul A. Monach, Larry W. Moreland, Aswin Nair, Christian Pagnoux, Kaitlin A. Quinn, Raheesh Ravindran, Philip Seo, Antoine G. SreihKenneth J. Warrington, Steven R. Ytterberg, Peter A. Merkel, Debashish Danda, Peter C. Grayson

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Objectives: To develop and replicate, using data-driven methods, a novel classification system in Takayasu's arteritis based on distribution of arterial lesions. Methods: Patients were included from four international cohorts at major academic centres: India (Christian Medical College Vellore); North America (National Institutes of Health, Vasculitis Clinical Research Consortium and Cleveland Clinic Foundation). All patients underwent whole-body angiography of the aorta and branch vessels, with categorization of arterial damage (stenosis, occlusion or aneurysm) in 13 territories. K-means cluster analysis was performed to identify subgroups of patients based on pattern of angiographic involvement. Cluster groups were identified in the Indian cohort and independently replicated in the North American cohorts. Results: A total of 806 patients with Takayasu's arteritis from India (n = 581) and North America (n = 225) were included. Three distinct clusters defined by arterial damage were identified in the Indian cohort and replicated in each of the North American cohorts. Patients in cluster one had significantly more disease in the abdominal aorta, renal and mesenteric arteries (P < 0.01). Patients in cluster two had significantly more bilateral disease in the carotid and subclavian arteries (P < 0.01). Compared with clusters one and two, patients in cluster three had asymmetric disease with fewer involved territories (P < 0.01). Demographics, clinical symptoms and clinical outcomes differed by cluster. Conclusion: This large study in Takayasu's arteritis identified and replicated three novel subsets of patients based on patterns of arterial damage. Angiographic-based disease classification requires validation by demonstrating potential aetiological or prognostic implications.

Original languageEnglish (US)
Pages (from-to)1118-1127
Number of pages10
JournalRheumatology (United Kingdom)
Volume59
Issue number5
DOIs
StatePublished - May 1 2020

Keywords

  • CT scanning
  • MRI
  • Takayasu's arteritis
  • cardiovascular
  • vasculitis

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

Fingerprint Dive into the research topics of 'Derivation of an angiographically based classification system in Takayasu's arteritis: An observational study from India and North America'. Together they form a unique fingerprint.

  • Cite this

    Goel, R., Gribbons, K. B., Carette, S., Cuthbertson, D., Hoffman, G. S., Joseph, G., Khalidi, N. A., Koening, C. L., Kumar, S., Langford, C., Maksimowicz-Mckinnon, K., McAlear, C. A., Monach, P. A., Moreland, L. W., Nair, A., Pagnoux, C., Quinn, K. A., Ravindran, R., Seo, P., ... Grayson, P. C. (2020). Derivation of an angiographically based classification system in Takayasu's arteritis: An observational study from India and North America. Rheumatology (United Kingdom), 59(5), 1118-1127. https://doi.org/10.1093/rheumatology/kez421