High incidence of severe ischaemic complications in patients with giant cell arteritis irrespective of platelet count and size, and platelet inhibition.
OBJECTIVE
Vision loss and ischaemic stroke are feared complications in GCA. We investigated how platelet count and size and platelet inhibition with ASA relate to ischaemic complications in patients with GCA.


METHODS
Charts of patients with GCA were retrospectively analysed. Jaw claudication, amaurosis fugax, blurred vision, ischaemic stroke and permanent visual loss were classified as 'ischaemic events'; ischaemic stroke and permanent visual loss were sub-grouped as 'severe ischaemic events'. The incidence of ischaemia and the association to the pre-defined covariates age, fever, ESR, platelet count and size and ASA treatment were assessed.


RESULTS
Eighty-five patients (mean age 73 yrs, 60% women, 78% biopsy-proven) were included in the analysis. Of the 85 patients, 62 (73%) presented with ischaemic events, 29/85 patients (34%) with severe ischaemic events. At the time of diagnosis 22/85 patients (26%) were treated with ASA. Of these 22 patients, 15 (68%) presented with ischaemic events, 7/22 patients (32%) with severe ischaemic events. In multivariate analysis, neither platelet count nor size or ASA treatment were significantly associated with ischaemic or severe ischaemic events.


CONCLUSIONS
The incidence of severe ischaemic events in patients with GCA was high, irrespective of platelet count and size and established ASA treatment.
Berger
C T
CT
Department of Internal Medicine, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland. bergerc@uhbs.ch
Wolbers
M
M
Meyer
P
P
Daikeler
T
T
Hess
C
C
D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000627:therapeutic use; D001792:Blood Platelets / Q000473:pathology; D002545:Brain Ischemia / Q000097:blood / Q000209:etiology; D048429:Cell Size; D005260:Female; D013700:Giant Cell Arteritis / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007511:Ischemia / Q000097:blood / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D018917:Optic Neuropathy, Ischemic / Q000097:blood / Q000209:etiology; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D010976:Platelet Count; D012189:Retrospective Studies; D020521:Stroke / Q000097:blood / Q000209:etiology; D014786:Vision Disorders / Q000097:blood / Q000209:etiology
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin