Session Title: Vasculitis
Session Type: Abstract Submissions (ACR)
Background/Purpose: To assess the effect of cardiovascular risk factors on incidence GCA within a longitudinal cohort study in which detailed information on cardiovascular risk factors has been collected.
Methods: The data source is the Reykjavik Study (RS), a population-based, prospective cohort study with a primary focus on cardiovascular disease. All persons born in 1907-1935 that were living in Reykjavik, Iceland or adjacent communities on December 1, 1967 were invited to participate. Subjects came for a study visit in 1967-1996 and information on cardiovascular risk factors, including smoking habits, blood pressure, diabetes, body mass index, and serum cholesterol was obtained. All temporal artery biopsies (TABs) obtained from 1961-2009 on members of the cohort were identified through all three pathology laboratories in Iceland. All TABs were re-examined in a standardized fashion by a single pathologist with expertise in vascular pathology. Incidence of GCA was calculated for exposed (GCA) and unexposed (no GCA) subjects and incidence rate ratios (IRR) were calculated with 95% confidence intervals adjusted for age and sex.
Results: Data were obtained from 19,241 subjects that were followed for a median 23.1 (IQR: 17.6-29.4) years after the age of 50. During the follow-up of 444,396 person-years, 194 subjects had GCA, corresponding to an incidence rate of 45.0 (95% CI: 38.8-51.2) per 100,000 person-years after the age of 50. Woman had increased incidence of GCA compared to men, IRR= 2.03 (95% CI: 1.49 – 2.76). BMI was inversely associated with GCA; subjects with a BMI>25 had an IRR= 0.68 (95% CI: 0.50-0.90). Smoking was inversely associated with GCA among men IRR= 0.51 (95% CI: 0.30-0.86), but not women IRR=1.12 (95% CI: 0.79-1.57). Hypertension was associated with incident GCA among men IRR= 1.91 (95% CI: 1.12-3.25), but not among women IRR= 0.86 (95% CI: 0.60-1.24). Serum cholesterol was not associated with incident GCA.
Conclusion: This study confirms a high incidence of GCA in Iceland. Lower BMI is associated with the occurrence of GCA. Among men, hypertension is positively associated with GCA and smoking is inversely associated with incident GCA.
P. A. Merkel,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/cardiovascular-risk-factors-and-incident-giant-cell-arteritis/