title: Risk for cardiovascular disease early and late after a diagnosis of giant-cell arteritis: a cohort study.
abstract: BACKGROUND
  Involvement of large arteries is well-documented in giant-cell arteritis (GCA), but the risk for cardiovascular events is not well-understood.
  
  
  OBJECTIVE
  To evaluate the risks for incident myocardial infarction (MI), cerebrovascular accident (CVA), and peripheral vascular disease (PVD) in individuals with incident GCA in a general population context.
  
  
  METHODS
  Observational cohort study.
  
  
  METHODS
  U.K. primary care database.
  
  
  METHODS
  3408 patients with incident GCA and 17 027 age- and sex-matched reference participants without baseline cardiovascular disease (MI, CVA, or PVD).
  
  
  METHODS
  Diagnoses of GCA, outcomes, and cardiovascular risk factors were identified from electronic medical records. One combined and 3 separate cohort analyses were conducted for the outcomes of MI, CVA, and PVD. The association of GCA with study outcomes is expressed with hazard ratios (HRs) with 95% CIs after adjustment for potential cardiovascular risk factors.
  
  
  RESULTS
  Among 3408 patients with GCA (73% female; mean age, 73 years), the incidence rates of MI, CVA, and PVD were 10.0, 8.0, and 4.2 events per 1000 person-years, respectively, versus 4.9, 6.3, and 2.0 events per 1000 person-years, respectively, among reference participants. The HRs were 1.70 (95% CI, 1.51 to 1.91) for the combined outcome, 2.06 (CI, 1.72 to 2.46) for MI, 1.28 (CI, 1.06 to 1.54) for CVA, and 2.13 (CI, 1.61 to 2.81) for PVD. The HRs were more pronounced in the first month after GCA diagnosis (combined HR, 4.92 [CI, 2.59 to 9.34]; HR for MI, 11.89 [CI, 2.40 to 59.00]; HR for CVA, 3.93 [CI, 1.76 to 8.79]; HR for PVD, 3.86 [CI, 0.78 to 19.17]).
  
  
  CONCLUSIONS
  Information on temporal arterial biopsies was not available, and there was a substantial amount of missing data on cardiovascular risk factors.
  
  
  CONCLUSIONS
  Giant-cell arteritis is associated with increased risks for MI, CVA, and PVD.
  
  
  BACKGROUND
  National Institute of Arthritis and Musculoskeletal and Skin Diseases.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Tomasson
authors.forename: Christine
authors.initials: C
authors.lastname: Peloquin
authors.forename: Aladdin
authors.initials: A
authors.lastname: Mohammad
authors.forename: Thorvardur J
authors.initials: TJ
authors.lastname: Love
authors.forename: Yuqing
authors.initials: Y
authors.lastname: Zhang
authors.forename: Hyon K
authors.initials: HK
authors.lastname: Choi
authors.forename: Peter A
authors.initials: PA
authors.lastname: Merkel
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications* / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D013700:Giant Cell Arteritis / Q000150:complications*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000453:epidemiology; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000453:epidemiology; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000453:epidemiology