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,...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
2015
|
| _version_ | 1826289573182832640 |
|---|---|
| author | Robson, J Kiran, A Maskell, J Hutchings, A Arden, N Dasgupta, B Hamilton, W Emin, A Culliford, D Luqmani, R |
| author_facet | Robson, J Kiran, A Maskell, J Hutchings, A Arden, N Dasgupta, B Hamilton, W Emin, A Culliford, D Luqmani, R |
| author_sort | Robson, J |
| collection | OXFORD |
| description | 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. |
| first_indexed | 2024-03-07T02:30:56Z |
| format | Journal article |
| id | oxford-uuid:a7351965-ea12-46a7-93a0-aa609a098b39 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T02:30:56Z |
| publishDate | 2015 |
| record_format | dspace |
| spelling | oxford-uuid:a7351965-ea12-46a7-93a0-aa609a098b392022-03-27T02:52:58ZThe relative risk of aortic aneurysm in patients with giant cell arteritis compared with the general population of the UK.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a7351965-ea12-46a7-93a0-aa609a098b39EnglishSymplectic Elements at Oxford2015Robson, JKiran, AMaskell, JHutchings, AArden, NDasgupta, BHamilton, WEmin, ACulliford, DLuqmani, ROBJECTIVES: 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. |
| spellingShingle | Robson, J Kiran, A Maskell, J Hutchings, A Arden, N Dasgupta, B Hamilton, W Emin, A Culliford, D Luqmani, R The relative risk of aortic aneurysm in patients with giant cell arteritis compared with the general population of the UK. |
| title | The relative risk of aortic aneurysm in patients with giant cell arteritis compared with the general population of the UK. |
| title_full | The relative risk of aortic aneurysm in patients with giant cell arteritis compared with the general population of the UK. |
| title_fullStr | The relative risk of aortic aneurysm in patients with giant cell arteritis compared with the general population of the UK. |
| title_full_unstemmed | The relative risk of aortic aneurysm in patients with giant cell arteritis compared with the general population of the UK. |
| title_short | The relative risk of aortic aneurysm in patients with giant cell arteritis compared with the general population of the UK. |
| title_sort | relative risk of aortic aneurysm in patients with giant cell arteritis compared with the general population of the uk |
| work_keys_str_mv | AT robsonj therelativeriskofaorticaneurysminpatientswithgiantcellarteritiscomparedwiththegeneralpopulationoftheuk AT kirana therelativeriskofaorticaneurysminpatientswithgiantcellarteritiscomparedwiththegeneralpopulationoftheuk AT maskellj therelativeriskofaorticaneurysminpatientswithgiantcellarteritiscomparedwiththegeneralpopulationoftheuk AT hutchingsa therelativeriskofaorticaneurysminpatientswithgiantcellarteritiscomparedwiththegeneralpopulationoftheuk AT ardenn therelativeriskofaorticaneurysminpatientswithgiantcellarteritiscomparedwiththegeneralpopulationoftheuk AT dasguptab therelativeriskofaorticaneurysminpatientswithgiantcellarteritiscomparedwiththegeneralpopulationoftheuk AT hamiltonw therelativeriskofaorticaneurysminpatientswithgiantcellarteritiscomparedwiththegeneralpopulationoftheuk AT emina therelativeriskofaorticaneurysminpatientswithgiantcellarteritiscomparedwiththegeneralpopulationoftheuk AT cullifordd therelativeriskofaorticaneurysminpatientswithgiantcellarteritiscomparedwiththegeneralpopulationoftheuk AT luqmanir therelativeriskofaorticaneurysminpatientswithgiantcellarteritiscomparedwiththegeneralpopulationoftheuk AT robsonj relativeriskofaorticaneurysminpatientswithgiantcellarteritiscomparedwiththegeneralpopulationoftheuk AT kirana relativeriskofaorticaneurysminpatientswithgiantcellarteritiscomparedwiththegeneralpopulationoftheuk AT maskellj relativeriskofaorticaneurysminpatientswithgiantcellarteritiscomparedwiththegeneralpopulationoftheuk AT hutchingsa relativeriskofaorticaneurysminpatientswithgiantcellarteritiscomparedwiththegeneralpopulationoftheuk AT ardenn relativeriskofaorticaneurysminpatientswithgiantcellarteritiscomparedwiththegeneralpopulationoftheuk AT dasguptab relativeriskofaorticaneurysminpatientswithgiantcellarteritiscomparedwiththegeneralpopulationoftheuk AT hamiltonw relativeriskofaorticaneurysminpatientswithgiantcellarteritiscomparedwiththegeneralpopulationoftheuk AT emina relativeriskofaorticaneurysminpatientswithgiantcellarteritiscomparedwiththegeneralpopulationoftheuk AT cullifordd relativeriskofaorticaneurysminpatientswithgiantcellarteritiscomparedwiththegeneralpopulationoftheuk AT luqmanir relativeriskofaorticaneurysminpatientswithgiantcellarteritiscomparedwiththegeneralpopulationoftheuk |