Evaluation of clinical measurements and development of new diagnostic criteria for Takayasu arteritis in a Chinese population.
OBJECTIVE
Takayasu arteritis (TA) is a chronic granulomatous large-vessel vasculitis. When diagnosing TA, the criteria designed by the American College of Rheumatology (ACR) are used commonly but they were just classification criteria. There is an urgent need for a new set of diagnostic criteria.


METHODS
One hundred and thirty-one TA patients and 132 control patients with other types of vascular disease were enrolled and both groups were distributed into a "training set" and a "validation set". All general information as well as clinical, laboratory and imaging data were collected. After comparing all the medical records of two groups in the training set, logistic regression and clinical judgment were used to form the new criteria for TA. The new criteria were tested by the validation set.


RESULTS
New TA diagnostic criteria within total score 26 include age (<40 years), female, chest pain/chest distress, amaurosis, vascular bruits, a decreased/absent pulse, involvement of the aortic arch or its major branches, and involvement of the abdominal aorta or its branches. Patients with a score ≥ 8 were diagnosed as TA. The sensitivity and specificity of our new criteria were 91.92% and 93.94%, respectively, higher than those of the ACR criteria (75.76%, 85.86%) and the Ishikawa criteria (56.57%, 94.95%). The areas under the ROC curves of the new criteria and ACR criteria were 0.981 and 0.868, respectively (p<0.001). Sensitivity and specificity tested in the validation set were 90.63% and 96.97%, respectively.


CONCLUSIONS
The new diagnostic criteria exhibited high sensitivity and specificity and have demonstrated to be feasible in the diagnosis of TA.
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
X
X
Kong
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
L
L
Ma
Department of Rheumatology, People's Hospital of Urumqi, Xinjiang, China.
L
L
Wu
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
H
H
Chen
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
L
L
Ma
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Y
Y
Sun
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
W
W
Wu
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Z
Z
Ji
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Z
Z
Zhang
Department of Rheumatology, Renji Hospital, Jiaotong University, Shanghai, China.
C
C
Yang
Department of Rheumatology, Renji Hospital, Jiaotong University, Shanghai, China.
S
S
Ye
Department of Rheumatology, Renji Hospital, Jiaotong University, Shanghai, China.
S
S
Chen
Department of Rheumatology, Changhai Hospital, Second Military Medical University, Shanghai, China.
S
S
Dai
Department of Rheumatology, Huashan Hospital, Fudan University, Shanghai, China.
Y
Y
Xue
Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China.
G
G
Qin
Department of Rheumatology, People's Hospital of Wuxi, Jiangsu, China.
Y
Y
Zou
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Q
Q
Yu
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
L
L
Jiang
D000328:Adult; D000367:Age Factors; D000368:Aged; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging* / Q000473:pathology; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000473:pathology; D044466:Asian People; D001766:Blindness / Q000209:etiology; D016022:Case-Control Studies; D002637:Chest Pain / Q000209:etiology; D002681:China; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012737:Sex Factors; D013625:Takayasu Arteritis / Q000150:complications / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed; D055815:Young Adult