Traditional and disease specific risk factors for cardiovascular events in ANCA-associated vasculitis: a multinational retrospective study.

Abstract

To investigate the occurrence of cardiovascular events (CVE) in a large cohort of patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) across the European Union, China, Turkey, Russia, UK, and USA. Patients with a definite diagnosis of AAV who were followed ≥3 months and had sufficient documentation were included. Data on myocardial infarction (MI) and stroke were collected retrospectively from tertiary vasculitis centers. Univariate and multivariate Cox regression models were used to estimate hazard ratios (HRs) and 95% CIs. Over a median follow-up of 62 (interquartile range: 23, 100) months, CVE (mostly MI) occurred in 245 (10.7%) of 2286 AAV patients with a higher frequency in China and the UK. On multivariate regression analysis, older age (55-64.9 years; HR 2.93, 95% CI: 1.99, 4.31), smoking (HR 1.98, 95% CI: 1.48, 2.64), Chinese origin (HR 4.24, 95% CI: 3.07, 5.85), pulmonary (HR 1.50, 95% CI: 1.09, 2.06) and kidney (HR 3.02, 95% CI: 2.08, 4.37) involvement were independent variables associated with a higher occurrence of CVE. We showed that geographic region and both traditional and disease specific (kidney involvement in particular) factors were independently associated with CVE. Proper assessment and management of modifiable cardiovascular risk factors are essential for prevention of cardiovascular morbidity in AAV patients.