Clinical features of intracranial vessel involvement in Takayasu's arteritis

Abstract

Objective: To analyze clinical characteristics of intracranial vessel involvement in Takayasu's arteritis (TA). Methods: Retrospectively analyzed 135 hospitalized TA patients' clinical data in Beijing Anzhen Hospital from November 2012 to November 2018. Based on intracranial artery (IA) complicated or not, TA patients were divided into two groups:32 patients within involvement and 103 patients without involvement. The difference in comparison of imaging types, basic data and laboratory test were analyzed. Results: The proportion of TA patients with intracranial vascular involvement was 23.7% (32/135) and the most common site was internal carotid artery (intracranial segment) (59.4%, 19/32). The incidences of hypertension and coronary heart disease were significantly higher in TA patients with intracranial vascular involvement compared with the patients without intracranial involvement (46.9% vs 26.2%, 21.9% vs 6.8%, χ(2)=4.863, 4.460, all P<0.05). The rate of tocilizumab treatment in the intracranial vascular involved group was higher than that in the group without intracranial vascular involvement (40.6% vs 19.4%, χ(2)=5.945, P<0.05). The platelet count in patients with intracranial involvement group was significantly lower than that in patients without intracranial involvement group [(218±55)×10(9)/L vs (272±71)×10(9)/L, t=-3.570, P<0.01], while the hemoglobin [(130±17) vs (121±18) g/L, t=2.363, P<0.05] and triglyceride [1.22(0.75, 1.64) vs 0.92(0.63, 1.21) mmol/L, U=1 017.000, P<0.01] were significantly higher than those without intracranial vascular involvement. Moreover, coronary artery involvement presented more frequently in the intracranial vascular involved group than the group without intracranial vascular involvement (43.8% vs 14.6%, χ(2)=12.331, P<0.01). Logistic regression analysis showed that the incidence of intracranial vascular disease in TA patients with coronary artery involvement was 4 times higher than that in patients without coronary artery lesions (OR=3.965, 95%CI:1.584-9.926, P=0.003). Conclusion: The proportion of intracranial vascular involvement in TA is not rare, TA patients with cardiovascular risk factors should be considered to strengthen imaging examination of intracranial vessels.