Author/Editor		Hočevar, Alojzija; Ješe, Rok; Tomšič, Matija; Rotar, Žiga
Title		Risk factors for severe cranial ischaemic complications in giant cell arteritis
Type		članek
Publication year		2020
Volume		str. str.
ISSN		1462-0324 - Rheumatology (Oxford, England)
Language		eng
Abstract		Objectives.Vision complications and a stroke represent severe cranial ischaemic complications (sCIC) associated with increased morbidity and mortality in GCA. We aimed to determine the risk factors for sCIC in GCA. Methods.We analysed the medical records of prospectively enrolled GCA patients diagnosed between September 2011 and August 2019, and compared the clinical and laboratory characteristics of patients with and without sCIC defined as either severe vision complications (diplopia, transient vision loss, permanent partial visionfield/acuity defect and permanent visual loss) or stroke. Results. During the 96-month observation period, we identified 295 new GCA patients [65.4% female, median (interquartile range) age 74.7 (67.3-80.0) years]. Sixty-one (20.7%) patients developed sCIC (52 isolated severe vision complications, 5 isolated ischaemic strokes and 4 patients with both complications). In a multivariable logisticregression model jaw claudication [odds ratio (OR) 3.43 (95% CI: 1.84, 6.42),P<0.001], smoking [OR 1.92(95% CI: 1.01, 3.65),P 0.046] and increasing age [OR 1.08 (95% CI: 1.04, 1.13),P<0.001] were significantlyassociated with sCIC. Higher CRP [OR 0.99 (0.99-1.00),P 0.011] decreased the risk of sCIC. When considered separately, the odds for severe vision complications increased with age and jaw claudication, and decreased with polymyalgia rheumatica, constitutional symptoms and higher CRP. Atrial fibrillation emerged as the sole independent predictor of ischaemic stroke. Conclusion.Increasing age, jaw claudication and smoking predicted sCIC, while higher CRP decreased the risk of sCIC in our GCA cohort.
Keywords		giant cell arteritis vision complications stroke velikanski celični arteritis zapleti vida možganska kap