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Extended report: The relative risk of aortic aneurysm in patients with giant cell arteritis compared with the general population of the UK

Extended report: The relative risk of aortic aneurysm in patients with giant cell arteritis compared with the general population of the UK
Extended report: The relative risk of aortic aneurysm in patients with giant cell arteritis compared with the general population of the UK
Objectives

To evaluate the risk of aortic aneurysm in patients with giant cell arteritis (GCA) compared with age-, gender- and location-matched controls.

Methods

A UK General Practice Research Database (GPRD) parallel cohort study of 6999 patients with GCA and 41?994 controls, matched on location, age and gender, was carried out. A competing risk model using aortic aneurysm as the primary outcome and non-aortic-aneurysm-related death as the competing risk was used to determine the relative risk (subhazard ratio) between non-GCA and GCA subjects, after adjustment for cardiovascular risk factors.

Results

Comparing the GCA cohort with the non-GCA cohort, the adjusted subhazard ratio (95% CI) for aortic aneurysm was 1.92 (1.52 to 2.41). Significant predictors of aortic aneurysm were being an ex-smoker (2.64 (2.03 to 3.43)) or a current smoker (3.37 (2.61 to 4.37)), previously taking antihypertensive drugs (1.57 (1.23 to 2.01)) and a history of diabetes (0.32 (0.19 to 0.56)) or cardiovascular disease (1.98 (1.50 to 2.63)). In a multivariate model of the GCA cohort, male gender (2.10 (1.38 to 3.19)), ex-smoker (2.20 (1.22 to 3.98)), current smoker (3.79 (2.20 to 6.53)), previous antihypertensive drugs (1.62 (1.00 to 2.61)) and diabetes (0.19 (0.05 to 0.77)) were significant predictors of aortic aneurysm.

Conclusions

Patients with GCA have a twofold increased risk of aortic aneurysm, and this should be considered within the range of other risk factors including male gender, age and smoking. A separate screening programme is not indicated. The protective effect of diabetes in the development of aortic aneurysms in patients with GCA is also demonstrated.
0003-4967
1-7
Robson, Joanna C.
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Kiran, Amit
4b4006e4-c155-408b-ac66-6342c7b3d0ee
Maskell, Joe
f10981fc-239d-4a91-acb6-d71cb9586529
Hutchings, Andrew
adf59104-d27e-4da7-8b5c-5b100f7b29ae
Arden, Nigel
23af958d-835c-4d79-be54-4bbe4c68077f
Dasgupta, Bhaskar
ed3e1cf7-24a7-438b-9b47-d2503e8c541a
Hamilton, William
1b1358fb-e603-44b2-bab2-93dce124b9f1
Emin, Akan
e206a400-7169-4409-99f8-28047f3c40d1
Culliford, David
25511573-74d3-422a-b0ee-dfe60f80df87
Luqmani, Raashid A.
f8f596eb-8406-448a-88e3-3ef4fd669796
Robson, Joanna C.
f72b1600-6e6a-4628-a969-4d6e11208eb2
Kiran, Amit
4b4006e4-c155-408b-ac66-6342c7b3d0ee
Maskell, Joe
f10981fc-239d-4a91-acb6-d71cb9586529
Hutchings, Andrew
adf59104-d27e-4da7-8b5c-5b100f7b29ae
Arden, Nigel
23af958d-835c-4d79-be54-4bbe4c68077f
Dasgupta, Bhaskar
ed3e1cf7-24a7-438b-9b47-d2503e8c541a
Hamilton, William
1b1358fb-e603-44b2-bab2-93dce124b9f1
Emin, Akan
e206a400-7169-4409-99f8-28047f3c40d1
Culliford, David
25511573-74d3-422a-b0ee-dfe60f80df87
Luqmani, Raashid A.
f8f596eb-8406-448a-88e3-3ef4fd669796

Robson, Joanna C., Kiran, Amit, Maskell, Joe, Hutchings, Andrew, Arden, Nigel, Dasgupta, Bhaskar, Hamilton, William, Emin, Akan, Culliford, David and Luqmani, Raashid A. (2013) Extended report: The relative risk of aortic aneurysm in patients with giant cell arteritis compared with the general population of the UK. Annals of the Rheumatic Diseases, 1-7. (doi:10.1136/annrheumdis-2013-204113).

Record type: Article

Abstract

Objectives

To evaluate the risk of aortic aneurysm in patients with giant cell arteritis (GCA) compared with age-, gender- and location-matched controls.

Methods

A UK General Practice Research Database (GPRD) parallel cohort study of 6999 patients with GCA and 41?994 controls, matched on location, age and gender, was carried out. A competing risk model using aortic aneurysm as the primary outcome and non-aortic-aneurysm-related death as the competing risk was used to determine the relative risk (subhazard ratio) between non-GCA and GCA subjects, after adjustment for cardiovascular risk factors.

Results

Comparing the GCA cohort with the non-GCA cohort, the adjusted subhazard ratio (95% CI) for aortic aneurysm was 1.92 (1.52 to 2.41). Significant predictors of aortic aneurysm were being an ex-smoker (2.64 (2.03 to 3.43)) or a current smoker (3.37 (2.61 to 4.37)), previously taking antihypertensive drugs (1.57 (1.23 to 2.01)) and a history of diabetes (0.32 (0.19 to 0.56)) or cardiovascular disease (1.98 (1.50 to 2.63)). In a multivariate model of the GCA cohort, male gender (2.10 (1.38 to 3.19)), ex-smoker (2.20 (1.22 to 3.98)), current smoker (3.79 (2.20 to 6.53)), previous antihypertensive drugs (1.62 (1.00 to 2.61)) and diabetes (0.19 (0.05 to 0.77)) were significant predictors of aortic aneurysm.

Conclusions

Patients with GCA have a twofold increased risk of aortic aneurysm, and this should be considered within the range of other risk factors including male gender, age and smoking. A separate screening programme is not indicated. The protective effect of diabetes in the development of aortic aneurysms in patients with GCA is also demonstrated.

Full text not available from this repository.

More information

Published date: 4 October 2013
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 361601
URI: https://eprints.soton.ac.uk/id/eprint/361601
ISSN: 0003-4967
PURE UUID: 1b3db99c-8618-417c-b048-0ddc35a8da10
ORCID for David Culliford: ORCID iD orcid.org/0000-0003-1663-0253

Catalogue record

Date deposited: 28 Jan 2014 16:39
Last modified: 19 Nov 2019 01:47

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