Survival predictors in biopsy-proven giant cell arteritis: A northern Italian population-based study

Pierluigi MacChioni, Luigi Boiardi, Francesco Muratore, Giovanna Restuccia, Alberto Cavazza, Nicolò Pipitone, Mariagrazia Catanoso, Pamela Mancuso, Ferdinando Luberto, Paolo Giorgi Rossi, Carlo Salvarani

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Abstract

Objective. To evaluate the influence of disease-related findings and treatment outcomes on survival in a populationbased cohort of Northern Italian patients with GCA. Methods. A total of 281 patients with incident temporal artery biopsy (TAB)-proven GCA, diagnosed over a 26-year period (19862012) and living in the Reggio Emilia area, were retrospectively evaluated. We analysed clinical, imaging and laboratory findings at diagnosis, pathological patterns of TAB, CS treatment and therapeutic outcomes, and traditional cardiovascular risk factors as factors predictive of survival. Results. Univariate analysis showed that increased mortality was associated with large vessel involvement at diagnosis [hazard ratio (HR) 5.84], while reduced mortality was associated with female sex (HR 0.66), PMR (HR 0.54), higher haemoglobin levels (HR 0.84) at diagnosis, long-term remission (HR 0.47) and inflammation limited to adventitia or to the adventitial vasa vasorum (HR 0.48) at TAB examination. Multivariate analysis confirmed the association between increased mortality and large vessel involvement (HR 5.14) at diagnosis, between reduced mortality and PMR (HR 0.57) at diagnosis and adventitial inflammation (HR 0.31) at TAB. Conclusion. PMR at diagnosis and inflammation limited to the adventitia at TAB appear to identify subsets of patients with more benign disease, while large vessel involvement at diagnosis is associated with reduced survival.

Original languageEnglish
Pages (from-to)609-616
Number of pages8
JournalRheumatology (United Kingdom)
Volume58
Issue number4
DOIs
Publication statusPublished - Apr 1 2019

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Giant Cell Arteritis
Temporal Arteries
Adventitia
Biopsy
Survival
Population
Mortality
Inflammation
Vasa Vasorum
Sex Ratio
Hemoglobins
Multivariate Analysis

Keywords

  • GCA
  • mortality
  • survival predictors
  • temporal artery biopsy

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

Cite this

Survival predictors in biopsy-proven giant cell arteritis : A northern Italian population-based study. / MacChioni, Pierluigi; Boiardi, Luigi; Muratore, Francesco; Restuccia, Giovanna; Cavazza, Alberto; Pipitone, Nicolò; Catanoso, Mariagrazia; Mancuso, Pamela; Luberto, Ferdinando; Rossi, Paolo Giorgi; Salvarani, Carlo.

In: Rheumatology (United Kingdom), Vol. 58, No. 4, 01.04.2019, p. 609-616.

Research output: Contribution to journalArticle

MacChioni, Pierluigi ; Boiardi, Luigi ; Muratore, Francesco ; Restuccia, Giovanna ; Cavazza, Alberto ; Pipitone, Nicolò ; Catanoso, Mariagrazia ; Mancuso, Pamela ; Luberto, Ferdinando ; Rossi, Paolo Giorgi ; Salvarani, Carlo. / Survival predictors in biopsy-proven giant cell arteritis : A northern Italian population-based study. In: Rheumatology (United Kingdom). 2019 ; Vol. 58, No. 4. pp. 609-616.
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