OP0143 PREDICTORS OF SEVERE CRANIAL ISCHEMIC COMPLICATIONS IN GIANT CELL ARTERITIS

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Background Vision disturbances and ischemic stroke represent severe ischemic complications of giant cell arteritis (GCA). Despite the fast track GCA pathway since 2011 at our secondary/tertiary rheumatology center, about 10% of patients still develop permanent vision loss (PVL) or stroke. Objectives We aimed to determine markers predicting severe cranial ischemic complications in GCA. Methods We analyzed medical records of prospectively collected GCA patients diagnosed between 01.09.2011 and 31.12.2018 and compared clinical and laboratory characteristics of patients with and without vision disturbances (diplopia, transient vision loss (TVL), PVL) or ischemic stroke. Results During the 88-month observation period, we identified 250 new GCA patients (63.2% female, median (IQR) age 74.9 (67.8-79.9) years, 83.3% histologically proven, 79.8% with positive temporal artery ultrasound, 30.3% with extracranial large vessel involvement). Fifty (20.0%) patients developed either vision disturbances (16 diplopia, 10 TVL or 19 PVL) or ischemic stroke (8); isolated vision disturbances in 42, and isolated stroke in 5 patients. Conventional cardiovascular risk factors (obesity, arterial hypertension, hyperlipidemia, diabetes mellitus, and smoking were not associated with severe cranial ischemic complications (Table 1). The patients with severe cranial ischemic complications had more frequently had atrial fibrillation (RR 2.4 (95%CI 1.3-4.4), p=0.011). Twenty-five from 35 patients with atrial fibrillation were already treated with anticoagulants (10/13 in the group with cranial ischemic complication and 15/22 without them). Besides, GCA cases with severe cranial ischemic complications were significantly older (p=0.006) and more commonly reported jaw claudication (RR 1.8 (95%CI 1.4-2.3), p Conclusion Increasing age and jaw claudication predicted severe cranial ischemic complications in our GCA cohort. Atrial fibrillation might represent an additional risk factor. Disclosure of Interests None declared