Aortic and coronary calcifications in Takayasu arteritis.
OBJECTIVE
Atherosclerosis is well recognized in Takayasu arteritis (TAK) and the associated plaques tend to be more common in areas of arteritis. We now report arterial wall calcification in a large group of TAK patients and controls. We hypothesized that the degree of coronary artery calcification would point to a systemic effect of inflammation while that in the thoracic aorta more of local inflammation.


METHODS
A total of 47 patients with TAK, 43 patients with SLE and 70 healthy controls (HC) were studied. The presence of coronary artery and thoracic aorta calcifications (ToAC) was investigated by multi-detector computed tomography (MDCT). Atherosclerotic plaques in the carotid arteries were screened using B mode ultrasound.


RESULTS
The frequency of coronary artery calcification was significantly increased among patients with SLE as compared to the healthy controls while the increase in TAK did not reach statistical significance. There were more TAK patients with ToAC among the TAK as compared to the SLE patients [21/47 (45%) vs 10/43 (23%), P = 0.033]. In addition, a circumferential type of calcification, vs a punctuate or linear type, was the more common type in 67% of patients with TAK whereas only the linear or punctuate type was seen in SLE patients and HC. SLE and TAK patients were found to have increased risk for carotid artery plaques. Among TAK patients, coronary artery calcification, ToAC and carotid artery plaques tend to be at sites of primary vasculitic involvement.


CONCLUSIONS
There is increased atherosclerosis in TAK and SLE. Vessel wall inflammation seems to be also important in the atherosclerosis associated with TAK.
Division of Rheumatology, Department of Medicine, Cerrahpasa Medical Faculty, University of Istanbul, Istanbul, Turkey. eseyahi@yahoo.com
Emire
E
Seyahi
Ayca
A
Ucgul
Deniz
D
Cebi Olgun
Serdal
S
Ugurlu
Canan
C
Akman
Onur
O
Tutar
Sebahattin
S
Yurdakul
Hasan
H
Yazici
D000328:Adult; D001027:Aortography; D050197:Atherosclerosis / Q000000981:diagnostic imaging; D002114:Calcinosis / Q000000981:diagnostic imaging*; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000000981:diagnostic imaging; D008875:Middle Aged; D013625:Takayasu Arteritis / Q000000981:diagnostic imaging*; D014463:Ultrasonography
Atherosclerosis; Carotid artery plaques; Coronary artery calcification; MDCT; Takayasu arteritis; Thoracic aorta calcification; USG