Patients with ANCA-Associated Vasculitis at Increased Risk for Coronary Artery Disease, Study Suggests

A new study suggests that patients with ANCA-associated vasculitis (AAVs) may be at an increased risk of developing ischemic stroke and coronary artery disease.

The study, “Risk of coronary artery disease and ischemic stroke in patients with ANCA-associated vasculitis. A French population-based study,” was presented at the European League Against Rheumatism (EULAR) Annual Congress in Madrid, June 14-17.

ANCA-associated vasculitis, including both granulomatosis with polyangiitis and microscopic polyangiitis, is a disease process that affects small blood vessels. Despite advancements in treatment that have improved survival for patients with AAV, they are still at an increased risk of developing complications related to cardiovascular disease.

To further assess the incidence, mortality, and predictors of cardiovascular disease in patients with AAV, researchers conducted a retrospective study of 125 patients with AAV who were diagnosed in Toulouse, France, between 1981 and 2015. Sixty-five of these patients were men, and the mean age of those enrolled in the study was 61.3.

Patients with granulomatosis with polyangiitis and microscopic polyangiitis were included while patients with eosinophilic granulomatosis with polyangiitis were excluded. A survival analysis was performed and predictors for cardiovascular disease in patients with AAV were also assessed.

After a mean follow-up of 88.4 months since AAV diagnosis, coronary artery disease developed in 10 patients while ischemic stroke developed in nine patients with AAV. Coronary artery disease was found to occur twice as often in patients with AAV compared to the general population, regardless of age differences. Ischemic stroke was found to occur three times as often.

Additionally, smoking habits and previous history of coronary artery disease at the time of AAV diagnosis were strongly associated with coronary artery disease occurrence. Smokers and patients with a prior history of heart disease were 8.8 and 10.3 times more likely to develop coronary artery disease, respectively. Mortality for AAV patients was found to be twice as much as the number in the general population.

The authors concluded, “Patients with AAV have a significantly increased risk of mortality and ischemic stroke and a non-statistically significant trend toward an increased risk of [coronary artery disease]. Monitoring for this complication and vigilance in modifying risk factors are particularly warranted in this patient population.”