Ischemic heart disease in patients from Northwest Spain with biopsy proven giant cell arteritis. A population based study.
OBJECTIVE
To assess the incidence, mortality, and predictors of ischemic heart disease (IHD) in patients from the Lugo region of Northwest Spain with biopsy-proven giant cell arteritis (GCA).


METHODS
Retrospective study of patients with biopsy-proven GCA diagnosed from 1981 to 2001 at the single hospital for a population of 250,000 people. A survival analysis was performed. Hazard ratios and standardized mortality ratio (SMR) as well as predictors of IHD in patients with biopsy-proven GCA were also assessed.


RESULTS
Nineteen (9%) of the 210 patients with biopsy-proven GCA diagnosed during the period of study had IHD. The incidence of IHD in patients with GCA was 12.6/1000 person-years at risk (95% CI 6.9-21.0). During the study period 1981-2000 the population aged > or = 50 years in Lugo was roughly 100,000, and the mortality rate due to IHD in patients with GCA for that population was 8/100,000. The SMR in patients with GCA due to IHD was 1.62 (95% CI 0.70-3.20). Mortality in patients with GCA who had IHD was higher than in those patients without IHD (age and sex adjusted hazard ratio 2.81, 95% CI 1.51-5.21; p = 0.001). Age (hazard ratio 1.15), hypertension (hazard ratio 2.51), and abnormal temporal artery on physical examination (hazard ratio 0.36) at the time of diagnosis of GCA were the best predictors of IHD over the followup period in patients with biopsy-proven GCA.


CONCLUSIONS
Our observations suggest that mortality due to IHD in patients from Lugo with GCA is not much higher than that reported in the Spanish population aged 50 years and older. However, mortality in patients with GCA with IHD is higher than in GCA patients without IHD.
Gonzalez-Gay
Miguel A
MA
Division of Rheumatology, Hospital Xeral-Calde, c) Dr. Ochoa s/n, 27004 Lugo, Spain. miguelaggay@hotmail.com
Rubiera
Gerardo
G
Piñeiro
Angela
A
Garcia-Porrua
Carlos
C
Pego-Reigosa
Robustiano
R
Gonzalez-Juanatey
Carlos
C
Sanchez-Andrade
Amalia
A
Llorca
Javier
J
D000368:Aged; D001706:Biopsy; D005260:Female; D013700:Giant Cell Arteritis / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000209:etiology / Q000401:mortality / Q000473:pathology; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis; D013699:Temporal Arteries / Q000276:immunology / Q000473:pathology