OP0070\u2005ONSET TO DIAGNOSIS TIME PREDICTS SURVIVAL RATE IN TAKAYASU ARTERITIS

Abstract

Takayasu arteritis (TA) is large vessel vasculitis. In spite of relatively high 5 to 15 years survival rate, TA affects young persons and causes major cardiovascular events, disability and preterm deaths [1]. Nowadays, though new high-resolution visualization and effective treatment options are available, quite a large number of TA patients remain undiagnosed and untreated for years [2].To assess the influence of timely TA diagnosis and treatment initiation on the survival rate and cardiovascular events risk.A retrospective cohort study included 183 patients (139 females, 44 males), enrolled during the period from 1979 to 2018 after TA diagnosis verification according to ACR1990 criteria [3]. All subjects have been followed up at the Sverdlovsk Regional Clinical Hospital 1. Cox regression model was used to compare survival rate.By enrollment, females median age was 35 [25%-75%: 24 - 44] and in males median age was 34 [26 -42]. Median time duration from the first symptoms onset to the diagnosis verification was 3 [1-7] years in females and [1.5 - 8] years in males. The most common affected arteries were subclavian (55%), carotid (53%), and renal (42%). 5-year survival rate was 92%; 10-year survival rate was 90%; 15-year survival rate was 80%. The median term of survival was 34 [20 - 41] years. 31 deaths (18 males and 13 females) occurred during the follow-up period. Median age of death was 36 [32-44] in females, and 50 [40-57]) in males. The average disease course duration at the time of death was 9.25 years, median term being 6.5 [3-16] in females and 5 [3-10] in males. Also a total of 72 cardiovascular events were recorded during the follow-up period: 27 in men and 45 in women. The median duration of AT course by the development of the first ever event was 10 (5 -20). There were 24 cases of ischemic stroke, 3 transient ischemic attacks, 4 cases of hemorrhagic stroke. Median age of the first ever event was 38 (30 - 49.5). Time duration 4 years or more from AT symptoms onset to diagnosis was associated with significantly more frequent cardiovascular events (OR 1.8; 95% CI 1.07 – 3.34); and premature deaths (see table) by the 5th year of follow up (OR 2.9; 1.27- 6.55).In a retrospective cohort, time duration 4 years or more from TA symptoms onset to diagnosis verification was associated with higher risk of cardiovascular events and lower survival rate.[1]Mirouse C. et al. Ann. Rheum. Dis. 2018; 77(2): 10-48[2]Dejaco C. et al. Ann. Rheum. Dis. 2018;77: 636-643[3]Arend W.P. et al. Arthritis Rheum. 1990; 3(8): 1129-1134.Artem Popov Speakers bureau: Novartis, Menarini, AstraZeneca, Pfizer, Severnaya Zvezda, Romepharm, Irina Borodina: None declared, Lubov Shardina: None declared