Burden of coronary artery calcification in ANCA-associated vasculitis
Background Cardiovascular disease (CVD) is a leading cause of death in ANCA-associated vasculitis (AAV). Screening and primary cardiovascular prevention may improve outcomes.Methods We identified patients in the 2002–2019 Mass General Brigham AAV cohort with thoracic CT scans obtained for other clin...
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BMJ Publishing Group
2025-01-01
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| Series: | RMD Open |
| Online Access: | https://rmdopen.bmj.com/content/11/1/e004774.full |
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| author | Claire Cook Brittany Weber Catherine Ahola Zachary S. Wallace Michael Hendrickson Anushri Parakh Sandeep Hedgire Michael Lu |
| author_facet | Claire Cook Brittany Weber Catherine Ahola Zachary S. Wallace Michael Hendrickson Anushri Parakh Sandeep Hedgire Michael Lu |
| author_sort | Claire Cook |
| collection | DOAJ |
| description | Background Cardiovascular disease (CVD) is a leading cause of death in ANCA-associated vasculitis (AAV). Screening and primary cardiovascular prevention may improve outcomes.Methods We identified patients in the 2002–2019 Mass General Brigham AAV cohort with thoracic CT scans obtained for other clinical purposes. Coronary artery calcium (CAC) scores and age, sex and race-standardised CAC percentiles were calculated. Quantile regression was used to identify differences by ANCA type, and Gray’s test examined differences in major adverse cardiac events by CAC score.Results Of 175 included patients, 127 (73%) were MPO-ANCA+and 48 (27%) were PR3-ANCA+. The median CAC score was 17 (IQR 0, 334) and CAC percentile was 45 (IQR 0, 78); 65 (39%) patients had CAC of ≥100. The total CAC score was higher in patients with MPO-ANCA+AAV vs PR3-ANCA+AAV (median 24 vs 1, p=0.003), as was the standardised CAC percentile (50th vs 34th, p=0.02). Of 116 (66%) patients with non-zero CAC scores, only 29 (25%) were on a statin. In a time-to-event analysis, CAC of 100 or higher trended towards association with higher risk of major adverse cardiovascular events (χ2=1.9, p=0.16).Conclusion A majority of patients with AAV had clinically significant CAC. There were differences in CAC burden among those with MPO-ANCA+AAV versus PR3-ANCA+AAV. Although CAC is associated with CVD risk and an indication for statins, the use was inconsistent. The role of CT imaging to screen for CVD and guide primary prevention in AAV requires further study. |
| format | Article |
| id | doaj-art-93c673e6d14c42debb86021536032506 |
| institution | Kabale University |
| issn | 2056-5933 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | RMD Open |
| spelling | doaj-art-93c673e6d14c42debb860215360325062025-01-07T04:35:09ZengBMJ Publishing GroupRMD Open2056-59332025-01-0111110.1136/rmdopen-2024-004774Burden of coronary artery calcification in ANCA-associated vasculitisClaire Cook0Brittany Weber1Catherine Ahola2Zachary S. Wallace3Michael Hendrickson4Anushri Parakh5Sandeep Hedgire6Michael Lu7Rheumatology and Allergy Clinical Epidemiology Research Center, MGH, Boston, Massachusetts, USACardiovascular Medicine, Brigham and Women`s Hospital, Boston, Massachusetts, USARheumatology and Allergy Clinical Epidemiology Research Center, MGH, Boston, Massachusetts, USADepartment of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USACardiovascular Imaging Research Center, Massachusetts General Hospital, Boston, Massachusetts, USACardiovascular Imaging Research Center, Massachusetts General Hospital, Boston, Massachusetts, USABackground Cardiovascular disease (CVD) is a leading cause of death in ANCA-associated vasculitis (AAV). Screening and primary cardiovascular prevention may improve outcomes.Methods We identified patients in the 2002–2019 Mass General Brigham AAV cohort with thoracic CT scans obtained for other clinical purposes. Coronary artery calcium (CAC) scores and age, sex and race-standardised CAC percentiles were calculated. Quantile regression was used to identify differences by ANCA type, and Gray’s test examined differences in major adverse cardiac events by CAC score.Results Of 175 included patients, 127 (73%) were MPO-ANCA+and 48 (27%) were PR3-ANCA+. The median CAC score was 17 (IQR 0, 334) and CAC percentile was 45 (IQR 0, 78); 65 (39%) patients had CAC of ≥100. The total CAC score was higher in patients with MPO-ANCA+AAV vs PR3-ANCA+AAV (median 24 vs 1, p=0.003), as was the standardised CAC percentile (50th vs 34th, p=0.02). Of 116 (66%) patients with non-zero CAC scores, only 29 (25%) were on a statin. In a time-to-event analysis, CAC of 100 or higher trended towards association with higher risk of major adverse cardiovascular events (χ2=1.9, p=0.16).Conclusion A majority of patients with AAV had clinically significant CAC. There were differences in CAC burden among those with MPO-ANCA+AAV versus PR3-ANCA+AAV. Although CAC is associated with CVD risk and an indication for statins, the use was inconsistent. The role of CT imaging to screen for CVD and guide primary prevention in AAV requires further study.https://rmdopen.bmj.com/content/11/1/e004774.full |
| spellingShingle | Claire Cook Brittany Weber Catherine Ahola Zachary S. Wallace Michael Hendrickson Anushri Parakh Sandeep Hedgire Michael Lu Burden of coronary artery calcification in ANCA-associated vasculitis RMD Open |
| title | Burden of coronary artery calcification in ANCA-associated vasculitis |
| title_full | Burden of coronary artery calcification in ANCA-associated vasculitis |
| title_fullStr | Burden of coronary artery calcification in ANCA-associated vasculitis |
| title_full_unstemmed | Burden of coronary artery calcification in ANCA-associated vasculitis |
| title_short | Burden of coronary artery calcification in ANCA-associated vasculitis |
| title_sort | burden of coronary artery calcification in anca associated vasculitis |
| url | https://rmdopen.bmj.com/content/11/1/e004774.full |
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