title: The thromboembolic risk in giant cell arteritis: a critical review of the literature.
abstract: Giant cell arteritis is a systemic vasculitis characterized by granulomatous inflammation of the aorta and its main vessels. Cardiovascular risk, both for arterial and venous thromboembolism, is increased in these patients, but the role of thromboprophylaxis is still debated. It should be suspected in elderly patients suffering from sudden onset severe headaches, jaw claudication, and visual disease. Early diagnosis is necessary because prognosis depends on the timeliness of treatment: this kind of arteritis can be complicated by vision loss and cerebrovascular strokes. Corticosteroids remain the cornerstone of the pharmacological treatment of GCA. Aspirin seems to be effective in cardiovascular prevention, while the use of anticoagulant therapy is controversial. Association with other rheumatological disease, particularly with polymyalgia rheumatica is well known, while possible association with antiphospholipid syndrome is not established. Large future trials may provide information about the optimal therapy. Other approaches with new drugs, such as TNF-alpha blockades, Il-6 and IL-1 blockade agents, need to be tested in larger trials.
authors: U.O.C. Medicina d'Urgenza, A.O.U. "S. Giovanni e Ruggi", Largo Città di Ippocrate 1, 84100 Salerno, Italy.
authors: A
authors: A
authors: Guida
authors: Regional Reference Centre for Coagulation Disorders, University "Federico II", Naples, Italy.
authors: A
authors: A
authors: Tufano
authors: U.O.C. Medicina Generale, A.O.U. "S. Giovanni e Ruggi", Largo Città di Ippocrate 1, 84100 Salerno, Italy.
authors: P
authors: P
authors: Perna
authors: U.O.C. Medicina Generale, A.O.U. "S. Giovanni e Ruggi", Largo Città di Ippocrate 1, 84100 Salerno, Italy.
authors: P
authors: P
authors: Moscato
authors: U.O.C. Medicina Generale, A.O.U. "S. Giovanni e Ruggi", Largo Città di Ippocrate 1, 84100 Salerno, Italy.
authors: M T
authors: MT
authors: De Donato
authors: U.O.C. Medicina Generale, A.O.U. "S. Giovanni e Ruggi", Largo Città di Ippocrate 1, 84100 Salerno, Italy.
authors: R
authors: R
authors: Finelli
authors: U.O.C. Medicina Generale, A.O.U. "S. Giovanni e Ruggi", Largo Città di Ippocrate 1, 84100 Salerno, Italy.
authors: D
authors: D
authors: Caputo
authors: Regional Reference Centre for Coagulation Disorders, University "Federico II", Naples, Italy.
authors: M N D
authors: MN
authors: Di Minno