OP10. INCIDENCE OF CARDIOVASCULAR EVENTS IN BIOPSY-PROVEN AND BIOPSY-NEGATIVE GIANT CELL ARTERITIS: THE PROSPECTIVE, MULTICENTRIC DOUBLE COHORT GRACG STUDY

Abstract

Background: Pre-existing atheromatous disease may be a risk factor for Giant Cell Arteritis (GCA). Also, coronary vasculitis, cerebro-vascular disease, and upper or lower limb arteritis may be related to GCA in some patients. Increased rates of cardiovascular events as compared with expected rates have been reported in Scandinavian populations. Our objective was to assess in a prospective, double cohort study, the relative risk of cardiovascular events in GCA patients compared with randomly selected, population based, sex- and age-matched controls included at the time of diagnosis of the cases. Methods: 396 GCA patients (288 females, 108 males, 271 biopsy proven, and 125 biopsy negative cases) have been included on pre-defined criteria at the time of diagnosis, along with 290 controls. A follow-up questionnaire has been sent every 6 months to their physician, over a 5-year period. The 5-year relative risk has been adjusted according to Mantel-Haenszel, and interval confidence computed according to Greenland-Robins. Results are given in the table. Cumulative incidence of stroke is significantly increased in cases, but remains always lower than 3%/6 months. Incidence of angina pectoris is lower than 5% per year. There are no differences between cases and controls as regard myocardial infarction, transient cerebral attack, or lower limb arteriopathy. Conclusion: Although overall mortality is similar in GCA patients and controls, incidence of stroke and angina pectoris is slightly increased in the former, and long-term anti-platelet therapy needs to be assessed.