Antiplatelet therapy for the prevention of arterial ischemic events in takayasu arteritis.
BACKGROUND
Vessel wall inflammation, atherosclerosis and hypercoagulability may be responsible for ischemic events in Takayasu arteritis (TA). No study has evaluated the effect of antiplatelet therapy for the prevention of ischemic events in TA.


RESULTS
Forty-eight patients who met the ACR Classification Criteria for TA under follow-up at the Vasculitis Unit of Universidade Federal de São Paulo were evaluated retrospectively for clinical manifestations, therapy and arterial ischemic events. The mean age at study was 38.0 years and the mean age at TA diagnosis was 29.1 years. Women comprised for 89.6% of patients and 60.4% were Caucasian. Risk factors for cardiovascular disease were found in 44 patients (91.7%) The most common comorbidities for TA patients were hypertension (77.1%), high low-density lipoprotein (45.8%) and obesity (16.7%). Antiplatelet therapy was used by 62.5% of patients whereas anticoagulants were used by 12.5%. Acute ischemic events occurred in 29.2% of patients. TA patients with ischemic events used significantly less antiplatelet agents (14.3%) than those without ischemic events (82.4%), P<0.0001. No difference concerning ischemic events was observed in patients on anticoagulant therapy (P=0.339). The 3 deaths of TA patients were observed only in those who had presented ischemic events (P=0.021). Antiplatelet agents had a protective effect against ischemic events (hazard ratio =0.055, 95% confidence interval: 0.06-0.514; P=0.011).


CONCLUSIONS
Antiplatelet therapy is associated with a lower frequency of ischemic events in patients with TA.
de Souza
Alexandre W S
AW
Rheumatology Division, Universidade Federal de São Paulo, São Paulo-SP, Brazil. alexandre_wagner@uol.com.br
Machado
Natália P
NP
Pereira
Vanessa M
VM
Arraes
Anne E D
AE
Reis Neto
Edgard T
ET
Mariz
Henrique A
HA
Sato
Emilia Inoue
EI
D000293:Adolescent; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001158:Arteries / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000175:diagnosis; D015897:Comorbidity; D005260:Female; D006801:Humans; D007511:Ischemia / Q000188:drug therapy / Q000517:prevention & control*; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D012189:Retrospective Studies; D012307:Risk Factors; D013625:Takayasu Arteritis / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome; D055815:Young Adult
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors