Background/Purpose: Giant cell arteritis (GCA) is an inflammatory vasculopathy affecting primarily medium and large sized arteries. Previous studies have demonstrated a higher prevalence of aortic aneurysm in patients with GCA. The current study was conducted to better describe the characteristics as well as predictors of aortic aneurysm in patients with GCA in US population using data from a large national database.

Methods: This is a retrospective cross-sectional study using data from National Inpatient Sample (NIS) spanning the period from January 2006 to December 2010. Diagnoses were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. STATA/MP Version 15 and R 4.0.0 were used for statistical analyses. Categorical variables were calculated using chi-square tests and continuous variables were compared using Student’s t-test or Wilcoxon rank-sum test based on the distribution of data. We also performed a multivariate logistic regression analysis to identify the potential risk factors and protective factors of aortic aneurysm in patients with GCA.

Results: We identified 263,384 records with a diagnosis of aortic aneurysm, 21,698 records with a diagnosis of GCA, and 387 records with concurrent GCA and aortic aneurysm. Among patients with aortic aneurysms, those with GCA were more likely to be older (mean age 78.6 vs 74.7, p < 0.01), to be female (33% vs 64%, p < 0.001), and to develop ruptured aortic aneurysms (9.3% vs 5.8%, p < 0.01). Patients with GCA were more likely to have thoracic aortic aneurysms (31.3% vs 16.0%, p < 0.001), whereas those without GCA were prone to abdominal aortic aneurysms (62% vs 79%, p< 0.001). In patients with thoracic aorta involvement, those with GCA had a longer hospital stay (8.2 vs 7.0 days, p < 0.01, Wilcoxon rank-sum test), but the mortality rates between the two groups were similar (p = 0.8). The multivariate logistic regression analysis showed that in patients with GCA, the presence of other aneurysms (OR 13.7, 95% CI: 6.1 – 27.3), aortic valve disorders (OR 3.02, 95% CI: 2.22 – 4.02), current or previous tobacco use (OR 2.03, 95% CI: 1.55 – 2.64), and hyperlipidemia (OR 1.29, 95% CI: 1.03 – 1.59) were possibly linked to the development of aortic aneurysm, while female gender (OR 0.65, 95% CI: 0.53 – 0.81) and diabetes mellitus (OR 0.46, 95% CI: 0.35 – 0.61) were potential protective factors.

Conclusion: Consistent with previous studies, GCA is more common in females, and it has a predilection to affect the thoracic aorta. Our study also suggests that GCA could be associated with the rupture of aortic aneurysms. The presence of other aneurysms, aortic valve disorders, tobacco use and hyperlipidemia are possible risk factors for the development of aortic aneurysm in patients with GCA, while female gender and diabetes mellitus are potential protective factors.

« Back to ACR Convergence 2020

ACR Meeting Abstracts - https://acrabstracts.org/abstract/aortic-aneurysm-in-giant-cell-arteritis-a-nationwide-analysis/