Predictors of cardiovascular events in patients with Takayasu arteritis.

Background: This study was aimed to analyze the factors associated with cardiovascular events and develop a prediction model to predict 10-year cardiovascular events probability in patients with Takayasu arteritis (TAK).

Methods: Patients with TAK were prospectively enrolled from seven clinical centers between July 2013 and March 2021. The Cox proportional hazard regression was used to assess factors associated with cardiovascular events and develop a prediction model. The model performance was measured by Harrell's concordance index (C-index), Brier score and calibration plots. The nomogram was used to calculate the 10-year cardiovascular events probability.

Results: A total of 702 patients (aged 29.2 ± 9.9 years; 623 [88.7%] women) were included. Cardiovascular events were observed in 94 patients (13.4%) after a median follow-up of 67 months (IQR 46-99). Elevated erythrocyte sedimentation rate (ESR) at disease onset (HR 2.30 [1.47-3.60]), pulmonary hypertension (HR 1.87 [0.93-3.77]), pulselessness (HR 1.73 [1.14-2.63]), diagnostic delay ≥ 3 years (HR 1.63 [1.01-2.65]), aortic regurgitation (HR 1.61 [1.01-2.56]), and age at diagnosis (HR 1.05 [1.02-1.07]) independently increased cardiovascular events and were included in the final model. The optimism-corrected C-index and Brier score of prediction model were 0.71 (0.66-0.76) and 0.072, respectively, and the calibration plots suggested good agreement between the observed and predicted probability of cardiovascular events.

Conclusion: Patients with TAK were at high risk of cardiovascular events. Advanced age at diagnosis, diagnosis delayed over 3 years, pulselessness, pulmonary hypertension, aortic regurgitation, and elevated ESR at disease onset were risk factors for cardiovascular events.