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Increased incidence of cardiovascular events in patients with antineutrophil cytoplasmic antibody-associated vasculitides: A matched-pair cohort study
Arthritis & Rheumatism, 11/05/09

Morgan MD et al. – The goal of this retrospective study was to explore the risk of cardiovascular disease in patients with antineutrophil cytoplasmic antibody-associated vasculitides (AAVs) and to assess contributing risk factors. Patients with AAVs appear at greater risk of cardiovascular disease, with increased risk in those with a previous history of cardiovascular disease, dialysis dependency, poor renal function at remission, or a history of smoking. Measures to reduce the risk of cardiovascular disease should be integral to the management of systemic vasculitis.

• Retrospective matched-pair cohort study
• 113 of 131 patients with AAVs from vasculitis clinic registry matched 1:1 for renal function, age at diagnosis, sex, smoking status, and previous history of cardiovascular disease to patients with noninflammatory chronic kidney disease (CKD)
• Cardiovascular events defined as ACS, new-onset angina, symptomatic peripheral vascular disease, stroke, and TIA

• Median followup times 3.4 years for AAV patients and 4.2 years for CKD patients
• More cardiovascular events occurred in AAV group (23 of 113) than in CKD group (16 of 113)
• Cox regression survival analysis showed significantly increased risk of cardiovascular event for AAV patients, with HR of 2.23 (95% confidence interval [95% CI] 1.1-4.4)
• Within cohort of AAV patients, most strongly predictive factors were previous history of cardiovascular disease (HR 4 [95% CI 1.7-9.8]), history of dialysis dependency (HR 4.3 [95% CI 1.5-12.1]), ever having smoked (HR 3.9 [95% CI 1.5-10]), age at diagnosis (HR 1.038 [95% CI 1.006-1.072]), estimated glomerular filtration rate at remission (HR 0.977 [95% CI 0.957-0.998]), and serum cholesterol concentration at presentation (HR 0.637 [95% CI 0.441-0.92])

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