Venous Thromboembolism May Be Increased in the Early Phases of ANCA-Associated Vasculitis and Could Be Associated With a High Body Mass Index: TR-VaS Experience.

OBJECTIVE

This study aims to assess the incidence and factors linked to venous thromboembolic events (VTE) in a large national cohort of antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) from the Turkish Vasculitis Study Group (TR-VaS).

METHOD: This retrospective analysis included patients with granulomatosis with polyangiitis, microscopic polyangiitis, renal-limited vasculitis, and eosinophilic granulomatosis with polyangiitis. VTE that occurred within 3 months before the diagnosis of AAV or during the follow-up period was classified as AAV-associated VTE (AAV-VTE). Demographic, clinical, and disease-related features, along with the presence of well-known VTE risk factors, were compared between AAV patients with and without VTE. Multivariate analyses were performed to identify independent risk factors linked to the development of AAV-VTE.

RESULTS

A total of 559 patients were included, and VTE was detected in 43 (7.7%). In univariate analysis, baseline body mass index (BMI) (HR: 1.13, 95% CI: 1.02-1.25, p = 0.01), erythrocyte sedimentation rate (HR: 1.01, 95% CI: 1.00-1.02, p = 0.04), BVAS score (HR: 1.05, 95% CI: 1.01-1.09, p = 0.01), renal involvement (HR: 2.01, CI: 0.96-4.20, p = 0.06), the presence of immobilization (HR: 11.4, 95% CI: 5.64-23.37, p < 0.001), and trauma (HR: 28.84, 95% CI: 3.5-215.7, p < 0.001) were identified as risk factors for VTE-AAV. In multivariate analysis, baseline BMI (HR: 1.14, CI: 1.02-1.26, p = 0.002) was the only independent risk factor for the development of VTE.

CONCLUSION

Our findings suggest that physicians caring for AAV patients should be cautious about the risk of VTE in patients with an elevated BMI and active disease, along with other recognized risk factors for VTE.