Comparison of Clinical Features at the Onset of Takayasu’s Arteritis According to Age and Sex

Author(s): Jin Wan, Shuying Qi, Hua Liao, Weiping Ci, Yanqiu Guo, Tian Wang*.

Journal Name: Current Vascular Pharmacology

Volume 18 , Issue 1 , 2020

Become EABM
Become Reviewer

Abstract:

Background: Takayasu’s arteritis (TA) is a large-vessel vasculitis that predominantly affects the aorta, pulmonary artery, and its main branches. The cause of TA is still unclear.

Objective: To identify the clinical characteristics of TA at onset in different patient groups.

Methods: The clinical manifestations, laboratory, and angiographic findings of 53 patients with TA based on age at onset and sex were retrospectively analysed.

Results: The ratio of the incidence of TA in males and females was 1:4. Chest pain, reduced glomerular filtration rate (GFR), and multivessel involvement were the most common symptoms at TA onset in male patients. 17% of patients had an onset age >40 years, and the percentage of TA patients >40 years old with chest pain was significantly higher [6 (66.7%) vs 13 (29.5%) and p=0.031] than that in TA patients <40 years old. However, their renal artery involvement [1 (11.1%) vs 21 (47.7%)), p=0.042], abdominal aorta lesion [0 (0.0%) vs 16 (38.1%), p=0.030], and multiple vessel involvement [2 (22.2%) vs. 32 (72.7%), p=0.004] were significantly less evident. Multivariate analysis showed that hypertension and thoracic aortic lesion were predisposing factors for TA diagnosis [odds ratio (OR)=3.918, 95% confidence interval (CI)=1.616-1566.185, p=0.026]. For patients with aortic insufficiency (OR=3.674, 95% CI=2.734-567.621, p=0.007) or aneurysm formation (OR=7.255, 95% CI=1.23-1628.614, p=0.044), ascending aortic lesion was an independent risk factor. Furthermore, patients >40 years with chest pain but no brachial pulse should be suspected to have TA.

Conclusion: Hypertension and thoracic aortic lesion are predisposing factors for the diagnosis of TA. Male with TA was more prone to present with chest pain, multivessel involvement, and reduced GFR.

Keywords: Age, sex, hypertension, thoracic aorta, clinical characteristics, takayasu's arteritis.

[1]
Lupi-Herrera E, Sánchez-Torres G, Marcushamer J, Mispireta J, Horwitz S, Vela JE. Takayasu’s arteritis. Clinical study of 107 cases. Am Heart J 1977; 93(1): 94-103.
[2]
Subramanyan R, Joy J, Balakrishnan KG. Natural history of aortoarteritis (Takayasu’s disease). Circulation 1989; 80(3): 429-37.
[3]
Vanoli M, Daina E, Salvarani C, et al. Takayasu’s arteritis: A study of 104 Italian patients. Arthritis Rheum 2005; 53(1): 100-7.
[4]
Alibaz-Öner F, Aydın SZ, Direskeneli H. Recent advances in Takayasu’s arteritis. Eur J Rheumatol 2015; 2(1): 24-30.
[5]
Arend WP, Michel BA, Bloch DA, et al. The American college of rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum 1990; 33(8): 1129-34.
[6]
Hata A, Noda M, Moriwaki R, Numano F. Angiographic findings of Takayasu arteritis: New classification. Int J Cardiol 1996; 54: 155-63.
[7]
Kerr G. Takayasu’s arteritis. Curr Opin Rheumatol 1994; 6(1): 32-8.
[8]
Sadurska E, Jawniak R, Majewski M, Czekajska-Chehab E. Takayasu arteritis as a cause of arterial hypertension. Case report and literature review. Eur J Pediatr 2012; 171(5): 863-9.
[9]
Sandhya P, Danda S, Danda D, et al. Tumour necrosis factor (TNF)-α-308 gene polymorphism in Indian patients with Takayasu’s arteritis - a pilot study. Indian J Med Res 2013; 137(4): 749-52.
[10]
Terao C, Yoshifuji H, Ohmura K, et al. Association of Takayasu arteritis with HLA-B 67:01 and two amino acids in HLA-B protein. Rheumatology (Oxford) 2013; 52(10): 1769-74.
[11]
Ohigashi H, Haraguchi G, Konishi M, et al. Improved prognosis of Takayasu arteritis over the past decade-comprehensive analysis of 106 patients. Circ J 2012; 76(4): 1004-11.
[12]
Mont’Alverne AR, Paula LE, Shinjo SK. Features of the onset of Takayasu’s arteritis according to gender. Arq Bras Cardiol 2013; 101(4): 359-63.
[13]
Richards BL, March L, Gabriel SE. Epidemiology of large-vessel vasculidities. Best Pract Res Clin Rheumatol 2010; 24(6): 871-83.
[14]
Maksimowicz-McKinnon K, Hoffman GS. Takayasu arteritis: What is the long-term prognosis? Rheum Dis Clin North Am 2007; 33(4): 777-86.
[15]
de Souza AW, de Carvalho JF. Diagnostic and classification criteria of Takayasu arteritis. J Autoimmun 2014; 48-49: 79-83.
[16]
Moriwaki R, Noda M, Yajima M, Sharma BK, Numano F. Clinical manifestations of Takayasu arteritis in India and Japan--new classification of angiographic findings. Angiology 1997; 48(5): 369-79.
[17]
Rosenthal T, Morag B, Rubinstein Z, Itzchak Y. Takayasu arteritis in Israel- update. Int J Cardiol 1996; 54: 137-40.
[18]
Maffei S, Di Renzo M, Bova G, Auteri A, Pasqui AL. Takayasu’s arteritis: A review of the literature. Intern Emerg Med 2006; 1(2): 105-12.
[19]
Johnston SL, Lock RJ, Gompels MM. Takayasu arteritis: A review. J Clin Pathol 2002; 55(7): 481-6.
[20]
Anrather J, Iadecola C. Inflammation and stroke: An overview. Neurotherapeutics 2016; 13(4): 661-70.
[21]
Francis A, Baynosa R. Ischaemia-reperfusion injury and hyperbaric oxygen pathways: A review of cellular mechanisms. Diving Hyperb Med 2017; 47(2): 110-7.
[22]
Li Cavoli G, Tortorici C, Bono L, Ferrantelli A, Giammarresi C, Rotolo U. Takayasu’s arteritis presenting as renovascular hypertension. Saudi J Kidney Dis Transpl 2013; 24(2): 384-6.
[23]
Nooshin D, Neda P, Shahdokht S, Ali J. Ten-year investigation of clinical, laboratory and radiologic manifestations and complications in patients with takayasu’s arteritis in three university hospitals. Malays J Med Sci 2013; 20(3): 44-50.
[24]
Bilge NS, Kaşifoğlu T, Cansu DU, Korkmaz C. Retrospective evaluation of 22 patients with Takayasu’s arteritis. Rheumatol Int 2012; 32(5): 1155-9.
[25]
Cong XL, Dai SM, Feng X, et al. Takayasu’s arteritis: Clinical features and outcomes of 125 patients in China. Clin Rheumatol 2010; 29(9): 973-81.
[26]
Alibaz-Oner F, Aydin SZ, Direskeneli H. Advances in the diagnosis, assessment and outcome of Takayasu’s arteritis. Clin Rheumatol 2013; 32(5): 541-6.
[27]
Karageorgaki ZT, Bertsias GK, Mavragani CP, et al. Takayasu arteritis: Epidemiological, clinical, and immunogenetic features in Greece. Clin Exp Rheumatol 2009; 27(1): 33-9.
[28]
Pipitone N, Versari A, Hunder GG, Salvarani C. Role of imaging in the diagnosis of large and medium-sized vessel vasculitis. Rheum Dis Clin North Am 2013; 39(3): 593-608.
[29]
Lee GY, Jang SY, Ko SM, et al. Cardiovascular manifestations of Takayasu arteritis and their relationship to the disease activity: Analysis of 204 Korean patients at a single center. Int J Cardiol 2012; 159(1): 14-20.
[30]
Ishikawa K, Maetani S. Long-term outcome for 120 Japanese patients with Takayasu’s disease. Clinical and statistical analyses of related prognostic factors. Circulation 1994; 90(4): 1855-60.
[31]
Numano F. The story of Takayasu arteritis. Rheumatology (Oxford) 2002; 41(1): 103-6.
[32]
Kobayashi Y, Numano F. Takayasu arteritis. Intern Med 2002; 41(1): 44-6.


Rights & PermissionsPrintExport Cite as

Article Details

VOLUME: 18
ISSUE: 1
Year: 2020
Page: [80 - 86]
Pages: 7
DOI: 10.2174/1570161117666190621152506
Price: $65

Article Metrics

PDF: 9
HTML: 1

Special-new-year-discount