Risk of cardiovascular events in giant cell arteritis: systematic review and meta-analysis.

IF 2.7 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology Pub Date : 2024-11-12 DOI:10.1016/j.hjc.2024.10.008

Sawai Singh Rathore, Prakhyath Srikaram, Samyukta Gudena, Swetha Manoj, Sanjana Reddy Allam, Mohammad Abdalla Hatamleh, Naga Siva Naveen Chodisetti, Shifa Parvez Shaikh, Chiranjeevee Ramanathan Saravanan, Nathnael Abera Woldehana, Bijay Mukesh Jeswani

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引用次数: 0

Abstract

Objective: Giant cell arteritis (GCA) is a chronic inflammatory condition associated with a significantly increased risk of various cardiovascular and thromboembolic events. Existing studies suggest an increased risk of cardiovascular disease in GCA, but results vary. This meta-analysis aims to quantify the association between GCA and the risk of various cardiovascular outcomes, providing a comprehensive evaluation of the cardiovascular burden in patients with GCA.

Methods: A comprehensive literature search was carried out using several databases. Studies were included based on predefined eligibility criteria. Using random effect models, Mantel-Haenszel odds ratios and associated 95% confidence intervals were produced to report the overall effect size. Funnel plots, Egger regression tests, and Begg-Mazumdar's rank correlation test were used to assess publication bias. The endpoint included any cardiovascular events, myocardial infarction (MI), coronary artery disease (CAD), aortic aneurysm/dissection, peripheral artery disease (PAD), stroke, and venous thromboembolism.

Results: The meta-analysis included 14 studies with a combined sample size of 609,954 patients, where the mean age was 73.8 years and 72.2% were female. Patients with GCA had significantly higher odds of experiencing any cardiovascular event (OR = 1.81, 95% CI = 1.55-2.15), acute myocardial infarction (OR = 1.63, 95% CI = 1.34-1.97), coronary artery disease (OR = 1.51, 95% CI = 1.09-2.08), aortic aneurysm/dissection (OR = 1.95, 95% CI = 1.55-2.46), peripheral artery disease (OR = 2.02, 95% CI = 1.69-2.41), stroke (OR = 1.52, 95% CI = 1.25-1.84), venous thromboembolism (OR = 1.92, 95% CI = 1.73-2.12), deep vein thrombosis (OR = 2.09, 95% CI = 1.50-2.91) and pulmonary embolism (OR = 2.45, 95% CI = 1.38-4.36). The heterogeneity of the outcomes ranged from low to high across different analyses. No publication bias was evident in the analysis.

Conclusion: The meta-analysis highlights the critical need for vigilant cardiovascular monitoring and proactive management strategies in GCA patients. Further research is needed to identify specific factors that contribute to cardiovascular complications in these patients.

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巨细胞动脉炎的心血管事件风险：系统回顾与元分析》。

背景：巨细胞动脉炎（GCA）是一种慢性炎症，与各种心血管和血栓栓塞事件的风险显著增加有关。现有研究表明，GCA 患者罹患心血管疾病的风险增加，但结果各不相同。本荟萃分析旨在量化 GCA 与各种心血管疾病风险之间的关联，从而全面评估 GCA 患者的心血管负担：方法：使用多个数据库进行了全面的文献检索。方法：利用多个数据库进行了全面的文献检索，并根据预先确定的资格标准纳入了相关研究。使用随机效应模型、Mantel-Haenszel 赔率和相关的 95% 置信区间来报告总体效应大小。漏斗图、Egger回归检验和Begg-Mazumdar秩相关检验用于评估发表偏倚。终点包括任何心血管事件、心肌梗死（MI）、冠状动脉疾病（CAD）、主动脉瘤/夹层、外周动脉疾病（PAD）、中风和静脉血栓栓塞：荟萃分析包括 14 项研究，样本量共计 609,954 例患者，平均年龄为 73.8 岁，72.2% 为女性。GCA 患者发生任何心血管事件（OR = 1.81，95% CI = 1.55 至 2.15）、急性心肌梗死（OR = 1.63，95% CI = 1.34 至 1.97）、冠状动脉疾病（OR = 1.51，95% CI = 1.09 至 2.08）、主动脉瘤/夹层（OR = 1.95，95% CI = 1.55 to 2.46）、外周动脉疾病（OR = 2.02，95% CI = 1.69 to 2.41）、中风（OR = 1.52，95% CI = 1.25 to 1.84）、静脉血栓栓塞（OR = 1.92，95% CI = 1.73 to 2.12）、深静脉血栓（OR = 2.09，95% CI = 1.50 to 2.91）和肺栓塞（OR = 2.45，95% CI = 1.38 to 4.36）。不同分析结果的异质性从低到高不等。分析中未发现明显的发表偏倚：荟萃分析强调了对 GCA 患者进行警惕性心血管监测和采取积极管理策略的迫切需要。还需要进一步研究，以确定导致这些患者出现心血管并发症的具体因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hellenic Journal of Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.90

自引率

7.30%

发文量

审稿时长

56 days

期刊介绍： The Hellenic Journal of Cardiology (International Edition, ISSN 1109-9666) is the official journal of the Hellenic Society of Cardiology and aims to publish high-quality articles on all aspects of cardiovascular medicine. A primary goal is to publish in each issue a number of original articles related to clinical and basic research. Many of these will be accompanied by invited editorial comments. Hot topics, such as molecular cardiology, and innovative cardiac imaging and electrophysiological mapping techniques, will appear frequently in the journal in the form of invited expert articles or special reports. The Editorial Committee also attaches great importance to subjects related to continuing medical education, the implementation of guidelines and cost effectiveness in cardiology.