Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Our aim was to describe patients with Giant-Cell Arteritis (GCA)-related stroke and to compare them to a control group of GCA patients without cerebrovascular involvement.
Methods: We created a retrospective multicenter cohort of patients with 1) GCA diagnosed according to the American College of Rheumatology (ACR) criteria between 1995 and 2015; 2) stroke revealing vasculitis or occurring within four weeks of starting GCA therapy. The control group comprised GCA patients with no history of stroke from patient-reporting centers. For each patient included with stroke, five randomised patients without stroke were included in the control group. All of them satisfied the ACR criteria
Results: Forty patients (21 (53%) women, median age 78 [60-91] years) with GCA-related stroke were included and were compared to 200 control patients with GCA. The stroke revealed GCA in 29 (73%) patients, whereas it occurred after diagnosis in 11 patients, 6 [1-14] days after the initiation of glucocorticosteroids (GC). No differences were observed between patients whose stroke revealed GCA and those suffering a stroke following GCA diagnosis. Vertebrobasilar territory was involved in 29 (73%) patients. Seven patients died within a few hours or days following a stroke. Compared to the control group, the stroke patients were older (78 [60-91] vs. 74 [50-94] years old, p=0.03), displayed more ophthalmic ischemic manifestations (25 (63%) vs. 50 (25%), p<0.001), had fewer anemia (22/37 (59%) vs. 137/167 (79%), p=0.03) and a higher level of hemoglobin at diagnosis (12.0 [9.4-16.1] vs. 11.1 [7.8-15.8] g/dl, p=0.02). Conversely, PMR was less frequent (8 (20%) vs. 76/198 (38%), p=0.03) and biological inflammatory parameters were lower at GCA diagnosis in patients with GCA-related stroke (ESR: 68 [10-119] mm vs. 80 [10-140], p=0.003; CRP: 61 [28-185] mg/l vs. 99 [6-400], p=0.04). Multivariate logistic regression revealed that the best predictors for the occurrence of stroke were the presence of ophthalmic ischemic manifestations at diagnosis (OR = 5, 95% CI, 2.14—12.33; p=0.0002) and absence of anemia (OR = 0.39, 95% CI, 0.16—0.99; p=0.04).
Conclusion: Stroke, especially in the vertebrobasilar territory, is more likely to occur in GCA patients who experience recent ophthalmic ischemic manifestations and who display low inflammatory parameters.
To cite this abstract in AMA style:de Boysson H, Liozon E, Lariviere D, Samson M, Boutemy J, Maigné G, Martin Silva N, Aouba A, Sacre K, Bienvenu B. Giant-Cell Arteritis Related Stroke: A Retrospective Multicentre Case-Control Study [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/giant-cell-arteritis-related-stroke-a-retrospective-multicentre-case-control-study/. Accessed November 21, 2019.
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