Update in Rheumatology

Vasculitis

Large-Artery Disease Was Common in Patients with Giant-Cell Arteritis

Giant-cell arteritis is among the most common forms of systemic vasculitis in adults; the incidence is 1 in 5000 among people older than 50 years of age. Giant-cell arteritis is also known as temporal arteritis because it typically affects the cranial arteries. However, other arteries are also frequently involved. Studies using positron emission tomography have suggested that about 50% of patients with giant-cell arteritis have large-artery involvement. Other studies have shown that among people with giant-cell arteritis, thoracic aortic aneurysm is 17.3 times more common and abdominal aortic aneurysm is 2.4 times more common. The strength of the risk for aortic aneurysm in people with giant-cell arteritis can be placed in context by noting that lung cancer is about 10 times more common in people who smoke than in those who do not.

In this study, the investigators wanted to determine the incidence and predictors of large-artery disease in giant-cell arteritis. They retrospectively evaluated 168 patients with giant-cell arteritis for large-artery disease and examined possible clinical predictors of large-artery disease. The study included all the residents of Olmstead County, Minnesota, who had received a diagnosis of giant-cell arteritis in the past 50 years.

The investigators found that 27% of patients with giant-cell arteritis (n = 46) developed large-artery disease, including 18% (n = 30) with aortic aneurysm or aortic dissection. In addition, 13% (n = 21) developed large-artery stenosis, which included stenosis of the subclavian artery or one of its major branches or stenosis of one of the cervical arteries (carotid, vertebral, or basilar artery). Sixty percent of all aortic lesions involved the thoracic aorta. Aortic …