Abstract 193: Major Adverse Cardiovascular Events And Conduction Abnormalities In Patients With ANCA-Associated Vasculitis: Retrospective Analysis From A Tertiary Referral Center

Abstract

Objective: Our aim was to determine the association of major adverse cardiovascular events (MACE) and cardiac conduction abnormalities in patients with history of ANCA-associated vasculitis. Methods: We retrospectively reviewed patients with ANCA vasculitis (n=125) from 2017-2020. Charts were reviewed to assess cardiovascular (CV) risk factors which included history of smoking, hypertension, hyperlipidemia, diabetes mellitus and chronic kidney disease. Incidence of MACE such as myocardial infarction (MI), stroke, heart failure (HF) was calculated retrospectively after the diagnosis of ANCA vasculitis. Similarly, the incidence of cardiac conduction abnormalities [atrial fibrillation (AF), first degree atrioventricular block (1AVB), and advanced heart block (ADVB)] was analyzed. Chi square and modified Poisson regression were used to calculate the incidence rate ratio (IRR) for MACE and conduction abnormalities. Results: Of 125 total patients, 77 (61.6%) had granulomatosis with polyangiitis (GPA), 37 (29.6%) had eosinophilic granulomatosis with polyangiitis (EGPA), and 11 (8.8%) had microscopic polyangiitis (MPA). Females were 68%. Mean age of the cohort was 58 +/- 15 with a mean BMI of 29.4 +/- 6.4 kg/m 2 . The unadjusted and adjusted (for age, gender, and CV risk factors) IRR for stroke was significantly lower in patients with EGPA and MPA vs. GPA (p<0.05), while IRR for HF was higher in EGPA vs. GPA (p<0.05) [Table 1]. IRR for AF was higher in patients with EGPA vs. GPA (p<0.02), while for ADVB it was lower (p<0.04) [Table 2]. The adjusted IRRs for MI and HF were higher in patients with EGPA and MPA but were not statistically significant [Table 1]. Conclusion: Incidence of stroke is higher in GPA patients compared with EGPA and MPA, while EGPA is more likely to lead to heart failure compared to GPA. Atrial fibrillation is more commonly seen in patients with EGPA, and advanced heart block is less common in EGPA compared with GPA.