Cardiovascular and renal morbidity in Takayasu arteritis: a population-based retrospective cohort study from UK.

Cardiovascular disease (CVD) is a major complication and cause of mortality in Takayasu arteritis (TA). The frequency of cardiovascular, cerebrovascular and renal morbidity or risk of death in TA is unknown in the UK. Population-based controlled studies are lacking in this area. METHODS Yearly cohort and cross-sectional studies were performed from 2000 to 2017 to estimate annual incidence rates and prevalence of TA respectively. An open retrospective matched cohort study was conducted to estimate risk of hypertension, diabetes, cardiovascular morbidity, chronic kidney disease (CKD) and all-cause mortality in TA, using a UK primary care database (IQVIA Medical Research Data). Risk (adjusted hazard ratio, aHR) of studied co-morbidities in TA compared to age and sex-matched controls was estimated. Changes in medication prescription were examined over time in both groups. RESULTS Overall, 142 patients with TA (median (IQR) age 53.4 (33.8-70.7) years) and 1371 matched controls were included. The annual incidence and prevalence of TA was 0.8/million and 7.5/million respectively. All-cause mortality was increased in TA (aHR 1.88, 95% CI 1.29-2.76). Patients with TA had higher risk of developing ischaemic heart disease, stroke/TIA, combined CVD and peripheral vascular disease than controls, but not hypertension, CKD, heart failure or diabetes during follow up. Only 50% of patients with TA requiring secondary CVD prevention were prescribed statins or anti-platelets within one year after study entry. CONCLUSION Cardiovascular morbidity was increased in patients with TA attending primary care services in the UK. Treatment with statins and anti-platelets in these patients was suboptimal.