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Which patients with giant cell arteritis will develop cardiovascular or cerebrovascular Disease? A clinical practice research datalink study

Which patients with giant cell arteritis will develop cardiovascular or cerebrovascular Disease? A clinical practice research datalink study
Which patients with giant cell arteritis will develop cardiovascular or cerebrovascular Disease? A clinical practice research datalink study
Objective: to evaluate the risk of cerebrovascular disease and cardiovascular disease (CVD) in patients with giant cell arteritis (GCA), and to identify predictors.

Methods: the UK Clinical Practice Research Datalink 1991–2010 was used for a parallel cohort study of 5827 patients with GCA and 37,090 age-, sex-, and location-matched controls. A multivariable competing risk model (non-cerebrovascular/CV-related death as the competing risk) determined the relative risk [subhazard ratio (SHR)] between patients with GCA compared with background controls for cerebrovascular disease, CVD, or either. Each cohort (GCA and controls) was then analyzed individually using the same multivariable model, with age and sex now present, to identify predictors of CVD or cerebrovascular disease.

Results: patients with GCA, compared with controls, had an increased risk SHR (95% CI) of cerebrovascular disease (1.45, 1.31–1.60), CVD (1.49, 1.37–1.62), or either (1.47, 1.37–1.57). In the GCA cohort, predictors of “cerebrovascular disease or CVD” included increasing age, > 80 years versus < 65 years (1.98, 1.62–2.42), male sex (1.20, 1.05–1.38), and socioeconomic status, most deprived quintile versus least deprived (1.34, 1.01–1.78). These predictors were also present within the non-GCA cohort.

Conclusion: patients with GCA are more likely to develop cerebrovascular disease or CVD than age-, sex-, and location-matched controls. In common with the non-GCA cohort, patients who are older, male, and from the most deprived compared with least deprived areas have a higher risk of cerebrovascular disease or CVD. Further work is needed to understand how this risk may be mediated by specific behavioral, social, and economic factors
0315-162X
1085-1092
Robson, J.C.
c98e5309-2e5b-4543-b532-ae444448867c
Kiran, A.
5c4f2210-4951-4226-a44b-e6ecfb9c5c71
Maskell, Joseph
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Hutchings, A.
de0d1e18-4180-4d53-92ae-daf35c8b6569
Arden, Nigel
23af958d-835c-4d79-be54-4bbe4c68077f
Dasgupta, B.
debd1b95-7459-4ac3-98ca-0abaea4526cb
Hamilton, W.
8739428e-d582-496a-b915-80f1c98afaef
Emin, A.
f605c60c-ff38-4d3c-8cb7-9516607b889f
Culliford, David
25511573-74d3-422a-b0ee-dfe60f80df87
Luqmani, R.
8ae75ebf-f0db-4d3e-a5de-c3c44ee6cec0
Robson, J.C.
c98e5309-2e5b-4543-b532-ae444448867c
Kiran, A.
5c4f2210-4951-4226-a44b-e6ecfb9c5c71
Maskell, Joseph
72aaf8da-a869-4724-ae24-86a924e8a9eb
Hutchings, A.
de0d1e18-4180-4d53-92ae-daf35c8b6569
Arden, Nigel
23af958d-835c-4d79-be54-4bbe4c68077f
Dasgupta, B.
debd1b95-7459-4ac3-98ca-0abaea4526cb
Hamilton, W.
8739428e-d582-496a-b915-80f1c98afaef
Emin, A.
f605c60c-ff38-4d3c-8cb7-9516607b889f
Culliford, David
25511573-74d3-422a-b0ee-dfe60f80df87
Luqmani, R.
8ae75ebf-f0db-4d3e-a5de-c3c44ee6cec0

Robson, J.C., Kiran, A., Maskell, Joseph, Hutchings, A., Arden, Nigel, Dasgupta, B., Hamilton, W., Emin, A., Culliford, David and Luqmani, R. (2016) Which patients with giant cell arteritis will develop cardiovascular or cerebrovascular Disease? A clinical practice research datalink study. The Journal of Rheumatology, 43 (6), 1085-1092. (doi:10.3899/jrheum.151024). (PMID:27084910)

Record type: Article

Abstract

Objective: to evaluate the risk of cerebrovascular disease and cardiovascular disease (CVD) in patients with giant cell arteritis (GCA), and to identify predictors.

Methods: the UK Clinical Practice Research Datalink 1991–2010 was used for a parallel cohort study of 5827 patients with GCA and 37,090 age-, sex-, and location-matched controls. A multivariable competing risk model (non-cerebrovascular/CV-related death as the competing risk) determined the relative risk [subhazard ratio (SHR)] between patients with GCA compared with background controls for cerebrovascular disease, CVD, or either. Each cohort (GCA and controls) was then analyzed individually using the same multivariable model, with age and sex now present, to identify predictors of CVD or cerebrovascular disease.

Results: patients with GCA, compared with controls, had an increased risk SHR (95% CI) of cerebrovascular disease (1.45, 1.31–1.60), CVD (1.49, 1.37–1.62), or either (1.47, 1.37–1.57). In the GCA cohort, predictors of “cerebrovascular disease or CVD” included increasing age, > 80 years versus < 65 years (1.98, 1.62–2.42), male sex (1.20, 1.05–1.38), and socioeconomic status, most deprived quintile versus least deprived (1.34, 1.01–1.78). These predictors were also present within the non-GCA cohort.

Conclusion: patients with GCA are more likely to develop cerebrovascular disease or CVD than age-, sex-, and location-matched controls. In common with the non-GCA cohort, patients who are older, male, and from the most deprived compared with least deprived areas have a higher risk of cerebrovascular disease or CVD. Further work is needed to understand how this risk may be mediated by specific behavioral, social, and economic factors

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More information

Accepted/In Press date: 12 February 2016
e-pub ahead of print date: 15 April 2016
Published date: 15 April 2016
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 397262
URI: http://eprints.soton.ac.uk/id/eprint/397262
ISSN: 0315-162X
PURE UUID: cf250ec4-cde3-48e2-9025-d2213a70de6d
ORCID for David Culliford: ORCID iD orcid.org/0000-0003-1663-0253

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Date deposited: 27 Jun 2016 08:13
Last modified: 17 Dec 2019 01:47

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Contributors

Author: J.C. Robson
Author: A. Kiran
Author: Joseph Maskell
Author: A. Hutchings
Author: Nigel Arden
Author: B. Dasgupta
Author: W. Hamilton
Author: A. Emin
Author: David Culliford ORCID iD
Author: R. Luqmani

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