Male Patients with Takayasu Arteritis and Coronary Artery Involvement are Prone to have Serious Coronary Stenosis and High Mortality.

Abstract

BACKGROUND\nTakayasu arteritis (TAK) is a rare autoimmune vasculitis that predominantly affects the aorta and its major branches, including the coronary arteries. Limited information is available regarding sex-specific differences in coronary artery involvement among TAK patients.\n\n\nOBJECTIVE\nTo assess the differences in coronary angiographic findings and the long-term outcomes between male and female TAK patients having coronary artery involvement.\n\n\nMETHODS\nThis retrospective cohort study included 87 TAK patients, grouped by sex, who underwent coronary angiography. General characteristics, clinical features, coronary angiographic findings, and therapeutic strategies were obtained from medical records. Major Adverse Cardiac Events (MACE), including death from any cause; myocardial infarction; repeated coronary artery revascularization; and rehospitalization due to unstable or progressive angina, or heart failure occurring during follow-up, were also recorded.\n\n\nRESULTS\nA total of 207 coronary lesions with stenosis were found in 87 TAK patients. The prevalence of ostial coronary lesions was lower in men than in women (9.1 vs. 23.9%, p=0.031). We observed less moderate stenosis (6.8 vs 22.7%, p=0.018) and more severe stenosis or occlusion (70.5 vs 46.0%, p=0.004) in the coronary lesions of male TAK patients. During the up to 7-year follow-up, death from any cause was greater in men than in women (21.4 vs. 1.5%, p=0.003); no other significant differences in MACE occurrence were observed between sexes.\n\n\nCONCLUSIONS\nAmong TAK patients with coronary artery involvement, males tend to have more severe coronary stenosis and a higher risk for long-term mortality than females.