Incidence and Predictors of Large-Artery Complication (Aortic Aneurysm, Aortic Dissection, and/or Large-Artery Stenosis) in Patients with Giant Cell Arteritis: A Population-Based Study over 50 Years

Dirk M. Nuenninghoff, Gene G. Hunder, Teresa J.H. Christianson, Robyn L. McClelland, Eric L. Matteson

Research output: Contribution to journalArticle

368 Scopus citations

Abstract

Objective. To determine the incidence and predictors of large-artery complication (aortic aneurysm, aortic dissection, and/or large-artery stenosis) in patients with giant cell arteritis (GCA). Methods. The cohort of all residents of Olmsted County, Minnesota, in whom GCA was diagnosed between January 1, 1950, and December 31, 1999, was followed up. The incidence of aortic aneurysm, aortic dissection, and large-artery stenosis was determined. Possible predictors and correlates of large-artery complication were assessed. Results. Forty-six incident cases of large-artery complication (representing 27% of the 168 patients in the cohort) were identified. These included 30 incident cases (18%) of aortic aneurysm and/or aortic dissection. Of these cases, 18 (11%) involved the thoracic aorta, with aortic dissection developing in 9 (5%). There were 21 incident cases (13%) of large-artery stenosis. Fifteen patients (9%) had incident cervical artery stenosis, and 6 (4%) had incident subclavian/axillary/brachial artery stenosis. One patient (0.6%) had incident iliac/femoral artery stenosis attributable to GCA. Hyperlipidemia and coronary artery disease were associated with aortic aneurysm and/or dissection (P < 0.05 for both). Cranial symptoms (headache, scalp tenderness, abnormal temporal arteries) were negatively associated with large-artery stenosis (hazard ratio [HR] 0.10 [95% confidence interval (95% CI) 0.03-0.35, P < 0.0005]), as was a higher erythrocyte sedimentation rate (HR 0.80 [95% CI 0.67-0.95, P < 0.05] per 10 mm/hour). Conclusion. Large-artery complication is common in GCA. Increased awareness of large-artery complication in GCA, particularly early-occurring aortic dissection, may decrease associated mortality.

Original languageEnglish (US)
Pages (from-to)3522-3531
Number of pages10
JournalArthritis and rheumatism
Volume48
Issue number12
DOIs
StatePublished - Dec 1 2003

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology
  • Pharmacology (medical)

Fingerprint Dive into the research topics of 'Incidence and Predictors of Large-Artery Complication (Aortic Aneurysm, Aortic Dissection, and/or Large-Artery Stenosis) in Patients with Giant Cell Arteritis: A Population-Based Study over 50 Years'. Together they form a unique fingerprint.

  • Cite this