RT Journal Article
SR Electronic
T1 Giant Cell Arteritis-related Stroke: A Retrospective Multicenter Case-control Study
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.161033
DO 10.3899/jrheum.161033
A1 Hubert de Boysson
A1 Eric Liozon
A1 Delphine Larivière
A1 Maxime Samson
A1 Jean-Jacques Parienti
A1 Jonathan Boutemy
A1 Gwénola Maigné
A1 Nicolas  Martin Silva
A1 Kim Ly
A1 Emmanuel Touzé
A1 Bernard Bonnotte
A1 Achille Aouba
A1 Karim Sacré
A1 Boris Bienvenu
YR 2017
UL http://www.jrheum.org/content/early/2017/01/05/jrheum.161033.abstract
AB Objective Our aim was to describe patients with giant cell arteritis (GCA)–related stroke and to compare them with a control group of GCA patients without stroke. Methods We created a retrospective multicenter cohort of patients with (1) GCA diagnosed according to the American College of Rheumatology criteria between 1995 and 2015, and (2) stroke occurring at the time of GCA diagnosis or occurring within 4 weeks of starting GCA therapy. The control group consisted of GCA patients without stroke. Results Forty patients [21 women (53%), median age 78 (60–91) yrs] with GCA-related stroke were included and were compared with 200 control patients. Stroke occurred at GCA diagnosis in 29 patients (73%), whereas it occurred after diagnosis in 11 patients. Vertebrobasilar territory was involved in 29 patients (73%). Seven patients died within a few hours or days following stroke. Compared with the control group, stroke patients had more ophthalmic ischemic symptoms [25 (63%) vs 50 (25%), p < 0.001]. Conversely, they demonstrated lower biological inflammatory variables [C-reactive protein: 61 (28–185) mg/l vs 99 (6–400) mg/l, p = 0.04] and less anemia [22/37 (59%) vs 137/167 (79%), p = 0.03] than patients without stroke. Multivariate logistic regression revealed that the best predictors for the occurrence of stroke were the presence of ophthalmic ischemic symptoms at diagnosis (OR 5, 95% CI 2.14–12.33, p = 0.0002) and the absence of anemia (OR 0.39, 95% CI 0.16–0.99, p = 0.04). Conclusion Stroke, especially in the vertebrobasilar territory, is more likely to occur in patients with GCA who experience recent ophthalmic ischemic symptoms and who exhibit low inflammatory variables.