PT  - JOURNAL ARTICLE
AU  - Hubert de Boysson
AU  - Eric Liozon
AU  - Delphine Larivière
AU  - Maxime Samson
AU  - Jean-Jacques Parienti
AU  - Jonathan Boutemy
AU  - Gwénola Maigné
AU  - Nicolas Martin Silva
AU  - Kim Ly
AU  - Emmanuel Touzé
AU  - Bernard Bonnotte
AU  - Achille Aouba
AU  - Karim Sacré
AU  - Boris Bienvenu
TI  - Giant Cell Arteritis–related Stroke: A Retrospective Multicenter Case-control Study
AID  - 10.3899/jrheum.161033
DP  - 2017 Mar 01
TA  - The Journal of Rheumatology
PG  - 297--303
VI  - 44
IP  - 3
4099  - http://www.jrheum.org/content/44/3/297.short
4100  - http://www.jrheum.org/content/44/3/297.full
SO  - J Rheumatol2017 Mar 01; 44
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.