The angiographic and clinical profile of patients with Takayasu aortoarteritis

Objective: Takayasu arteritis is a rare, chronic, inflammatory disease that primarily affects the aorta and its major branches. It mainly affects young females, and it can cause significant morbidity and mortality if untreated. The aim of this study was to evaluate the demographic profile, clinical manifestations, diagnostic features, angiographic findings in patients with aortoarteritis (Takayasu arteritis). Methods: We enrolled prospectively 116 patients with Takayasu arteritis who came to Cardiology OPD at tertiary cardiac care hospital. We looked for constitutional symptoms, heart-related symptoms, systemic hypertension, neurological symptoms and upper & lower limb fatigue and claudication. We evaluated our patients using different diagnostic criteria: clinical, ACR criteria and Indian Takayasu Activity score. We also studied the angiographic profile and lesion characteristics in these patients, based on peripheral and coronary angiograms. Results: We studied patients consisted of 14 male patients (12.1%) and 102 female patients (87.9%). Type V Takayasu arteritis was most common type (36.2%). Fatigue (60%) was most common cardinal symptom followed by myalgia (30%) and arthralgia (10%). About 43% of patients had neurological symptoms. Systemic hypertension (67%) was the most common manifestation of renal involvement. 110(95%) of the patients met clinical criteria and 105(91%) patients had American College of Rheumatology (ACR) score ≥3. Angiographic evidence of left renal artery stenosis was more (20%) than right renal artery stenosis (15%). bilateral renal artery involvement was found in 29% of patients. Conclusion: Type V Takayasu arteritis was most common type (36.2%) of total study population. Hypertension and subclavian artery involvement both were seen in 2/3rd of population. Angiographic evidence of right and left renal artery stenosis was seen in 15% and 20% respectively, while bilateral renal artery involvement was found in 29% of patients. Take home message: Takayasu arteritis rarely involves the coronary arteries. Angiographic evidence of right and left renal artery stenosis was observed in 15% and 20% of patients, respectively, with bilateral renal artery involvement found in 29% of patients.