Stroke frequency, associated factors, and clinical features in primary systemic vasculitis: a multicentric observational study

Objectives: The cerebral vessels may be affected in primary systemic vasculitis (PSV), but little is known about cerebrovascular events (CVEs) in this population. This study aimed to determine the frequency of CVEs at the time of diagnosis of PSV, to identify factors associated with CVEs in PSV, and...

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Main Authors: Geraldes, R, Santos, M, Ponte, C, Craven, A, Barra, L, Robson, JC, Hammam, N, Springer, J, Henes, J, Hocevar, A, Putaala, J, Santos, E, Rajasekhar, L, Daikeler, T, Karadag, O, Costa, A, Khalidi, N, Pagnoux, C, Canhão, P, Melo, TPE, Fonseca, AC, Ferro, JM, Fonseca, JE, Suppiah, R, Luqmani, RA
Format: Journal article
Language:English
Published: Springer 2024
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author Geraldes, R
Santos, M
Ponte, C
Craven, A
Barra, L
Robson, JC
Hammam, N
Springer, J
Henes, J
Hocevar, A
Putaala, J
Santos, E
Rajasekhar, L
Daikeler, T
Karadag, O
Costa, A
Khalidi, N
Pagnoux, C
Canhão, P
Melo, TPE
Fonseca, AC
Ferro, JM
Fonseca, JE
Suppiah, R
Luqmani, RA
author_facet Geraldes, R
Santos, M
Ponte, C
Craven, A
Barra, L
Robson, JC
Hammam, N
Springer, J
Henes, J
Hocevar, A
Putaala, J
Santos, E
Rajasekhar, L
Daikeler, T
Karadag, O
Costa, A
Khalidi, N
Pagnoux, C
Canhão, P
Melo, TPE
Fonseca, AC
Ferro, JM
Fonseca, JE
Suppiah, R
Luqmani, RA
author_sort Geraldes, R
collection OXFORD
description Objectives: The cerebral vessels may be affected in primary systemic vasculitis (PSV), but little is known about cerebrovascular events (CVEs) in this population. This study aimed to determine the frequency of CVEs at the time of diagnosis of PSV, to identify factors associated with CVEs in PSV, and to explore features and outcomes of stroke in patients with PSV. Methods: Data from adults newly diagnosed with PSV within the Diagnostic and Classification Criteria in VASculitis (DCVAS) study were analysed. Demographics, risk factors for vascular disease, and clinical features were compared between patients with PSV with and without CVE. Stroke subtypes and cumulative incidence of recurrent CVE during a prospective 6-month follow-up were also assessed. Results: The analysis included 4828 PSV patients, and a CVE was reported in 169 (3.50%, 95% CI 3.00–4.06): 102 (2.13% 95% CI 1.73–2.56) with stroke and 81 (1.68% 95% CI 1.33–2.08) with transient ischemic attack (TIA). The frequency of CVE was highest in Behçet’s disease (9.5%, 95% CI 5.79–14.37), polyarteritis nodosa (6.2%, 95% CI 3.25–10.61), and Takayasu’s arteritis (6.0%, 95% CI 4.30–8.19), and lowest in microscopic polyangiitis (2.2%, 95% CI 1.09–3.86), granulomatosis with polyangiitis (2.0%, 95% CI 1.20–3.01), cryoglobulinaemic vasculitis (1.9%, 95% CI 0.05–9.89), and IgA-vasculitis (Henoch-Schönlein) (0.4%, 95% CI 0.01–2.05). PSV patients had a 11.9% cumulative incidence of recurrent CVE during a 6-month follow-up period. Conclusion: CVEs affect a significant proportion of patients at time of PSV diagnosis, and the frequency varies widely among different vasculitis, being higher in Behçet’s. Overall, CVE in PSV is not explained by traditional vascular risk factors and has a high risk of CVE recurrence.
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spelling oxford-uuid:73d99c4c-f171-4a97-9631-7746898fcd862024-05-30T20:07:02ZStroke frequency, associated factors, and clinical features in primary systemic vasculitis: a multicentric observational studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:73d99c4c-f171-4a97-9631-7746898fcd86EnglishJisc Publications RouterSpringer2024Geraldes, RSantos, MPonte, CCraven, ABarra, LRobson, JCHammam, NSpringer, JHenes, JHocevar, APutaala, JSantos, ERajasekhar, LDaikeler, TKaradag, OCosta, AKhalidi, NPagnoux, CCanhão, PMelo, TPEFonseca, ACFerro, JMFonseca, JESuppiah, RLuqmani, RAObjectives: The cerebral vessels may be affected in primary systemic vasculitis (PSV), but little is known about cerebrovascular events (CVEs) in this population. This study aimed to determine the frequency of CVEs at the time of diagnosis of PSV, to identify factors associated with CVEs in PSV, and to explore features and outcomes of stroke in patients with PSV. Methods: Data from adults newly diagnosed with PSV within the Diagnostic and Classification Criteria in VASculitis (DCVAS) study were analysed. Demographics, risk factors for vascular disease, and clinical features were compared between patients with PSV with and without CVE. Stroke subtypes and cumulative incidence of recurrent CVE during a prospective 6-month follow-up were also assessed. Results: The analysis included 4828 PSV patients, and a CVE was reported in 169 (3.50%, 95% CI 3.00–4.06): 102 (2.13% 95% CI 1.73–2.56) with stroke and 81 (1.68% 95% CI 1.33–2.08) with transient ischemic attack (TIA). The frequency of CVE was highest in Behçet’s disease (9.5%, 95% CI 5.79–14.37), polyarteritis nodosa (6.2%, 95% CI 3.25–10.61), and Takayasu’s arteritis (6.0%, 95% CI 4.30–8.19), and lowest in microscopic polyangiitis (2.2%, 95% CI 1.09–3.86), granulomatosis with polyangiitis (2.0%, 95% CI 1.20–3.01), cryoglobulinaemic vasculitis (1.9%, 95% CI 0.05–9.89), and IgA-vasculitis (Henoch-Schönlein) (0.4%, 95% CI 0.01–2.05). PSV patients had a 11.9% cumulative incidence of recurrent CVE during a 6-month follow-up period. Conclusion: CVEs affect a significant proportion of patients at time of PSV diagnosis, and the frequency varies widely among different vasculitis, being higher in Behçet’s. Overall, CVE in PSV is not explained by traditional vascular risk factors and has a high risk of CVE recurrence.
spellingShingle Geraldes, R
Santos, M
Ponte, C
Craven, A
Barra, L
Robson, JC
Hammam, N
Springer, J
Henes, J
Hocevar, A
Putaala, J
Santos, E
Rajasekhar, L
Daikeler, T
Karadag, O
Costa, A
Khalidi, N
Pagnoux, C
Canhão, P
Melo, TPE
Fonseca, AC
Ferro, JM
Fonseca, JE
Suppiah, R
Luqmani, RA
Stroke frequency, associated factors, and clinical features in primary systemic vasculitis: a multicentric observational study
title Stroke frequency, associated factors, and clinical features in primary systemic vasculitis: a multicentric observational study
title_full Stroke frequency, associated factors, and clinical features in primary systemic vasculitis: a multicentric observational study
title_fullStr Stroke frequency, associated factors, and clinical features in primary systemic vasculitis: a multicentric observational study
title_full_unstemmed Stroke frequency, associated factors, and clinical features in primary systemic vasculitis: a multicentric observational study
title_short Stroke frequency, associated factors, and clinical features in primary systemic vasculitis: a multicentric observational study
title_sort stroke frequency associated factors and clinical features in primary systemic vasculitis a multicentric observational study
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