Validation of Angiographic Patterns of Disease in a Turkish Cohort of Patients with Takayasu’s Arteritis

K. Bates Gribbons¹, SEMA KAYMAZ-TAHRA², Fatma Alibaz³, Ertugrul Cagri bolek⁴, Omer Karadag⁵, Burak Ince⁶, Murat Inanc⁷, Sinem Kocaer⁸, Fatos Onen⁹, KENAN AKSU¹⁰, Gokhan Keser¹¹, Askin Ates¹², Ayten Yazici¹³, Ayse Cefle¹³, Nilufer Alpay Kanitez¹⁴, Ahmet Omma¹⁵, Onay Gercik¹⁶, Servet Akar¹⁷, Veli Cobankara¹⁸, Nazife Sule Yasar Bilge¹⁹, Timucin Kasifoglu²⁰, Mete Kara¹¹, Kaitlin Quinn²¹, Peter Grayson²², Peter Merkel²³ and Haner Direskeneli²⁴, ¹McGovern Medical School, Colleyville, TX, ²Marmara University Faculty of Medicine, Rheumatology, Istanbul, Turkey, ³Marmara University, School of Medicine, Rheumatology, Istanbul, Turkey, ⁴Vasculitis Translational Research Program, NIAMS, NIH, US, Lanham, MD, ⁵Hacettepe University, Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Ankara, Turkey, ⁶Istanbul Faculty of Medicine, Istanbul University, Division of Rheumatology, İstanbul, Turkey, ⁷Istanbul University Faculty of Medicine, Istanbul, Turkey, ⁸Dokuz Eylul University, Izmer, Turkey, ⁹Dokuz Eylul University, Izmir, Turkey, ¹⁰EGE UNIV. FACULTY of MEDICINE, IZMIR, Turkey, ¹¹Ege University, İzmir, Turkey, ¹²Ankara University, Ankara, Turkey, ¹³Kocaeli University, Kocaeli, Turkey, ¹⁴Koc University School of Medicine, Istanbul, Turkey, ¹⁵Ankara City Hospital, Istanbul, Turkey, ¹⁶Izmir Katip Celebi University, Izmir, Turkey, ¹⁷Izmir Katip Celebi University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey, ¹⁸Pamukkale University, Denizli, Turkey, ¹⁹Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey, ²⁰Osmangazi University Department of Rheumatology, Eskişehir, Turkey, ²¹National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Washington, DC, ²²National Institutes of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, MD, ²³University of Pennsylvania, Philadelphia, PA, ²⁴Marmara University, Istanbul, Turkey

Meeting: ACR Convergence 2021

Keywords: Imaging, Takayasu.s arteritis, Vasculitis

Session Information

Date: Tuesday, November 9, 2021

Title: Vasculitis – Non-ANCA-Associated & Related Disorders Poster II (1862–1888)

Session Type: Poster Session D

Session Time: 8:30AM-10:30AM

Background/Purpose: Previous studies using computer-driven methods have identified subsets of patients with Takayasu’s arteritis based on angiographic patterns of disease. These subsets were consistent between independent cohorts in North America and India, however, the prevalence of each subset differed between continent. The objective of this current study was to validate in an independent cohort from Turkey angiographic patterns of disease in Takayasu’s arteritis and determine if the prevalence of these patterns is more similar to cohorts from India, North America, or neither.

Methods: Angiograph data were derived from records of patients with Takayasu’s arteritis from 12 tertiary rheumatology centers in Turkey. All patients underwent whole-body angiography of the aorta and branch vessels, with categorization of involvement (stenosis, occlusion, or aneurysm) in 13 arterial territories. K-means cluster analysis was performed to identify subgroups of patients based on pattern of angiographic involvement.

Results: Data from 421 patients in the cohort in Turkey were available for analysis. Using K-means clustering, three distinct clusters were identified for the Turkish cohort; these three clusters were identical to those previously identified in the Indian and North American cohorts (Table 1). Patients in Cluster 1 have significantly more disease in the abdominal aorta, renal, and mesenteric arteries (p < 0.01). Patients in Cluster 2 have significantly more bilateral disease in the carotid and subclavian arteries (p < 0.01). Compared to patients in Clusters 1 and 2, patients in Cluster 3 have asymmetric disease with fewer involved territories (p < 0.01).

The prevalence in each of the three clusters for patients from Turkey (current analysis) compared to the prevalences for patients from India and North America (previously published data) is outlined in Table 2. The distribution of patients among the three clusters was quite similar among patients from Turkey and North America (p = 0.79), but these two cohorts differed in this respect from patients from India.

Conclusion: This study provides strong, independent confirmation that there are distinct subsets of Takayasu’s arteritis based on angiographic disease. These patterns are consistent between continents; however, the prevalence of each pattern differs. Genetic and/or environmental factors may contribute to patterns of angiographic disease in patients with Takayasu’s arteritis.

Table 1. Arterial distribution in clusters for a Turkish cohort of patients with Takayasu’s arteritis. A heatmap of arterial distribution, where the darker the red indicates that more patients within that cluster had involvement of the territory. Displayed in each cell is the number and percent of patients in the cluster that had involvement of the territory.

Table 2. Distribution of patients with Takayasu’s arteritis in angiographically-defined clusters among patients in India, North America, and Turkey

Disclosures: K. Gribbons, None; S. KAYMAZ-TAHRA, None; F. Alibaz, None; E. bolek, None; O. Karadag, Omer Karadag has received research grants from Roche, Pfzer as study investigator and received consulting fees from Celltrion., 6; B. Ince, None; M. Inanc, None; S. Kocaer, None; F. Onen, Pfizer, 1, 6, Abbvie, 1, 6, MSD, 6, Amgen, 1, 6, Novartis, 1, 6, Lily, 1, 6, UCB, 1, 6, Roche, 1, 6, Jansenn, 6, Celltrion, 6, Menarini, 1, 6; K. AKSU, None; G. Keser, None; A. Ates, None; A. Yazici, None; A. Cefle, None; N. Alpay Kanitez, None; A. Omma, None; O. Gercik, None; S. Akar, AbbVie, 2, 5, 6, Lilly, 2, 5, 6, MSD, 2, 5, 6, Novartis, 2, 5, 6, Pfizer, 2, 5, 6, Roche, 2, 5, 6, Janssen, 2, 5, 6, UCB, 2, 5, 6, Amgen, 2, 5, 6, Gilead, 2, 5, 6, Abdi Ibrahim, 2, 5, 6, Ilko, 2, 5, 6; V. Cobankara, None; N. Yasar Bilge, None; T. Kasifoglu, None; M. Kara, None; K. Quinn, None; P. Grayson, None; P. Merkel, AbbVie, 2, 5, AstraZeneca, 2, 5, Boeringher-Ingelheim, 2, 5, Bristol-Myers Squibb, 2, 5, ChemoCentryx, 2, 5, CSL Behring, 2, Dynacure, 2, Eicos, 2, EMDSerono, 2, Forbius, 2, 5, Genentech/Roche, 2, 5, Genzyme/Sanofi, 2, 5, GlaxoSmithKline, 2, 5, InflaRx, 2, 5, Jannsen, 2, Kiniksa, 2, Magenta, 2, Neutrolis, 2, Novartis, 2, Pfizer, 2, Sanofi, 5, Star Therapeutics, 2, Takeda, 2, Talaris, 2, UpToDate, 9; H. Direskeneli, None.

To cite this abstract in AMA style:

Gribbons K, KAYMAZ-TAHRA S, Alibaz F, bolek E, Karadag O, Ince B, Inanc M, Kocaer S, Onen F, AKSU K, Keser G, Ates A, Yazici A, Cefle A, Alpay Kanitez N, Omma A, Gercik O, Akar S, Cobankara V, Yasar Bilge N, Kasifoglu T, Kara M, Quinn K, Grayson P, Merkel P, Direskeneli H. Validation of Angiographic Patterns of Disease in a Turkish Cohort of Patients with Takayasu’s Arteritis [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/validation-of-angiographic-patterns-of-disease-in-a-turkish-cohort-of-patients-with-takayasus-arteritis/. Accessed .

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