Background/Purpose:

Visual manifestations such as diplopia, amaurosis fugax or blindness occur in up to half of the giant cell arteritis (GCA) patients. Some studies have shown that the use of warfarin or aspirin reduces the ischemic complications in GCA patients. Low dose aspirin is recommended by EULAR in all patients with GCA. The aim of this study was to calculate the number of GCA patients who receive low-dose aspirin after the diagnosis is made and examine whether the use of anti-coagulant or anti-platelets really protects against visual ischemic complications.

Methods:

GCA patients diagnosed for the period March 2010 through May 2013 were identified retrospectively. All the patients have a positive ultrasound (halo sign) of the temporal vessels and/or large vessels (carotid, axillary) and met the American College of Rheumatology classification criteria. Initial use of aspirin or warfarin was documented. Initiation of aspirin treatment in the patients after the diagnosis was made was also registered. A chi-squared test was used for group comparison and statistical significance was defined as p<0.05.

Results:

Fifty-one patients were diagnosed with GCA during the inclusion period. Thirteen patients suffered from visual manifestations (6 from permanent visual loss in one or both eyes). In this group, 2 patients had been on warfarin and 4 on aspirin. The corresponding numbers for the group without visual manifestations were 6 patients on warfarin and 5 on aspirin. No significant differences in visual manifestations were observed between the two groups, neither for those on warfarin (p=0.97) nor for those on aspirin (p=0.15). The number of patients who received aspirin after the diagnosis of GCA was recorded and include 11 patients (33%). Three of 7 GCA patients with visual manifestations who were not on anti-coagulation or anti-platelet treatment before diagnosis, received aspirin as a supplementary therapy.

Conclusion:

In our study, which included only a small number of patients with GCA, the use of anti-coagulants or anti-platelets was not protective against visual manifestations. This is in contrast with previous published studies. Only 33% of GCA patients received anti-platelet treatment after the diagnosis of GCA was made. Further studies are warranted to clarify the role of anti-platelet treatment in GCA.

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« Back to 2013 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/does-the-treatment-with-anti-coagulants-and-anti-platelets-protect-giant-cell-arteritis-patients-from-visual-manifestations/