Atherosclerosis in patients with biopsy-proven giant cell arteritis.
OBJECTIVE
To examine the presence of atherosclerosis in a series of giant cell arteritis (GCA) patients attended to in a community hospital and to determine whether clinical features or steroid therapy might be associated with the development of atherosclerotic disease.


METHODS
Forty consecutive patients diagnosed with biopsy-proven GCA, periodically followed at the rheumatology outpatient clinic of Hospital Xeral-Calde, Lugo (Spain), who had ended steroid therapy and had at least 3 years of followup were assessed for the presence of atherosclerosis by determination of the carotid intima-media thickness (IMT) and carotid plaques using high-resolution B-mode ultrasound. Forty matched controls were also studied.


RESULTS
GCA patients exhibited less carotid artery IMT than did matched controls (mean +/- SD 1.01 +/- 0.16 mm versus 1.13 +/- 0.20 mm; P = 0.005; difference in means 0.12, 95% confidence interval 0.04-0.20). Patients who required steroid therapy for >2 years had greater mean +/- SD carotid IMT (1.04 +/- 0.17 mm versus 0.95 +/- 0.15 mm) but the difference was not statistically significant (P = 0.10). A positive correlation between age at the time of the study and the carotid artery IMT in GCA patients was observed (r = 0.673, P < 0.001). However, adjusting for age, sex, and classic atherosclerosis risk factors, no significant correlation between carotid IMT and the routine laboratory markers of inflammation assessed at the time of disease diagnosis, disease duration, or cumulative prednisone dose was found.


CONCLUSIONS
The present study demonstrates that atherosclerotic macrovascular disease is not increased in patients with GCA.
Gonzalez-Juanatey
Carlos
C
Hospital Xeral-Calde, Lugo, Spain.
Lopez-Diaz
Maria J
MJ
Martin
Javier
J
Llorca
Javier
J
Gonzalez-Gay
Miguel A
MA
D000368:Aged; D050197:Atherosclerosis / Q000139:chemically induced / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D001706:Biopsy; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D013700:Giant Cell Arteritis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography
D005938:Glucocorticoids; D011241:Prednisone