Ahn, Joong Kyong; Hwang, Jiwon; Choi, Chan-Bum; Seo, Gi Hyeon
Joint bone spine
2023Mar ; 90 ( 2 ) :105498.
PMID : 36423779
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Ahn, Joong Kyong - Division of Rheumatology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Hwang, Jiwon - Division of Rheumatology, Department of Internal Medicine, Samsung Changwon
Choi, Chan-Bum - Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases,
Seo, Gi Hyeon - Health Insurance Review and Assessment Service, Wonju, Republic of Korea.
ABSTRACT
OBJECTIVES: To investigate the incidence and risk of cerebro-cardiovascular comorbidities (stroke, acute myocardial infarction, venous thromboembolism, and pulmonary embolism) in anti-neutrophil cytoplasmic antibody-associated vasculitis using nationwide Korean population-based medical claims data.
METHODS: We identified 1905 patients with newly diagnosed anti-neutrophil cytoplasmic antibody-associated vasculitis during 2009-2019. Incidence rates and hazard ratios with 95% confidence intervals were calculated to estimate the risk of cerebro-cardiovascular comorbidities in these patients and compared to age- and sex-matched controls (1:10) using the Cox proportional hazards model.
RESULTS: Most patients had microscopic polyangiitis (42.5%), followed by granulomatosis with polyangiitis (29.1%) and eosinophilic granulomatosis with polyangiitis (28.4%). The annual incidence rate of anti-neutrophil cytoplasmic antibody-associated vasculitis in 2019 was 0.55 per 100,000 person-years. Cerebro-cardiovascular comorbidities occurred in 12.6%. Stroke was most common (64.6%), followed by venous thromboembolism (34.6%), pulmonary embolism (18.3%), and acute myocardial infarction (5.4%). Korean patients with anti-neutrophil cytoplasmic antibody-associated vasculitis were at a significantly (2.3 times) higher overall risk for cerebro-cardiovascular comorbidities than the general population (adjusted hazard ratios, 4.5, 3.1, and 2.0 times higher for pulmonary embolism, venous thromboembolism, and stroke, respectively). These findings were similar for patients with each subtype of anti-neutrophil cytoplasmic antibody-associated vasculitis.
CONCLUSIONS: This is the first nationwide population-based study to demonstrate a significant risk of cerebro-cardiovascular comorbidities as complications of anti-neutrophil cytoplasmic antibody-associated vasculitis in Korean patients. Knowing these risks may enable personalized patient care and improve overall survival. CI - Copyright ¨Ï 2022 Societe francaise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.
keyword
Anti-neutrophil cytoplasmic antibody-associated vasculitis; Cerebro-cardiovascular disease; Comorbidities; Incidence rate; Risk
MESH
Humans, *Granulomatosis with Polyangiitis, *Venous Thromboembolism/epidemiology, *Churg-Strauss Syndrome, Antibodies, Antineutrophil Cytoplasmic, *Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/diagnosis, *Pulmonary Embolism/epidemiology, *Stroke/diagnosis/epidemiology, *Myocardial Infarction/epidemiology
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