0424: Cardiovascular involvements in Takayasu arteritis in Tunisia: clinical study of 43 cases

Introduction Takayasu arteritis (TA) is a rare systemic vasculitis. The aim of this study was to describe cardiovascular involvements in Tunisian patients with TA. Patients and Methods Retrospective study of patients with TA (American College of Rheumatology criteria) admitted in an internal medicine department from 1992 to 2015. Results Forty three patients were identified. Sex ratio M/F was 0.16. Mean age of Takayasu first manifestation was 36.2 years. Eleven patients complained of chest pain and 76.74% of intermittent limb claudicating (upper and lower limbs). 35 patients had pulse disturbance mainly radial pulse (n=28) and 23 patients had artery hypertension. Vascular murmur was noted in 62.79% of cases. Aortic murmur was systolic in 6 cases and diastolic in 3 cases (aortic valve regurgitation). Electrocardiogram showed abnormalities in 9 cases: 1 right bundle branch block, 2 complete left bundle branch block, 3 left ventricular hypertrophy, 2 atrial fibrillation and T negative wave from V3 to V6. Biological inflammatory syndrome was found in 32 patients. Aortic arch, its branches (n=33) and left supra clavicular artery (n=24) were the most common involvements. Thirty-three patients received corticosteroids and 13 had immunosuppressant drugs. Eighteen patients received antiplatelet agents and 6 underwent surgery. Angioplasty was performed in 5 patients. Outcome was good in 14% of cases. Three patients died (stroke). Conclusion Our study confirmed the female predominance and the frequency of hypertension. These results are common to the North African data previously published and confirm the particularity of TA in our region, which is different from the Asian one.