The Canadian journal of cardiology · 2025
Predictors of Cardiovascular Events in Patients With Takayasu Arteritis.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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He Shiping, Rong Zhan, Wang Yanhong, Wu Zhenbiao, Li Hongbin, Pan Lili, Duan Xinwang, Wu Lijun, Zhang Hongfeng, Yang Yunjiao, Li Jing, Zeng Xiaofeng
Аннотация
BACKGROUND: This study aimed to analyze the factors associated with cardiovascular events and develop a prediction model to predict 10-year cardiovascular events probability in patients with Takayasu arteritis (TAK).
METHODS: Patients with TAK were prospectively enrolled from 7 clinical centres between July 2013 and March 2021. The Cox proportional hazard regression was used to assess factors associated with cardiovascular events and develop a prediction model. The model performance was measured by Harrell's concordance index (C-index), Brier score, and calibration plots. The nomogram was used to calculate the 10-year cardiovascular events probability.
RESULTS: A total of 702 patients (aged 29.2 ± 9.9 years; 623 [88.7%] women) were included. Cardiovascular events were observed in 94 patients (13.4%) after a median follow-up of 67 months (interquartile range [IQR]: 46-99). Elevated erythrocyte sedimentation rate (ESR) at disease onset (hazard ratio [HR], 2.30 [1.47-3.60]), pulmonary hypertension (HR, 1.87 [0.93-3.77]), pulselessness (HR, 1.73 [1.14-2.63]), diagnostic delay ≥ 3 years (HR, 1.63 [1.01-2.65]), aortic regurgitation (HR, 1.61 [1.01-2.56]), and age at diagnosis (HR, 1.05 [1.02-1.07]) independently increased cardiovascular events and were included in the final model. The optimism-corrected C-index and Brier score of prediction model were 0.71 (0.66-0.76) and 0.072, respectively, and the calibration plots suggested good agreement between the observed and predicted probability of cardiovascular events.
CONCLUSIONS: Patients with TAK were at high risk of cardiovascular events. Advanced age at diagnosis, diagnosis delayed over 3 years, pulselessness, pulmonary hypertension, aortic regurgitation, and elevated ESR at disease onset were risk factors for cardiovascular events.
CLINICAL TRIAL REGISTRATION: JS-2038.
METHODS: Patients with TAK were prospectively enrolled from 7 clinical centres between July 2013 and March 2021. The Cox proportional hazard regression was used to assess factors associated with cardiovascular events and develop a prediction model. The model performance was measured by Harrell's concordance index (C-index), Brier score, and calibration plots. The nomogram was used to calculate the 10-year cardiovascular events probability.
RESULTS: A total of 702 patients (aged 29.2 ± 9.9 years; 623 [88.7%] women) were included. Cardiovascular events were observed in 94 patients (13.4%) after a median follow-up of 67 months (interquartile range [IQR]: 46-99). Elevated erythrocyte sedimentation rate (ESR) at disease onset (hazard ratio [HR], 2.30 [1.47-3.60]), pulmonary hypertension (HR, 1.87 [0.93-3.77]), pulselessness (HR, 1.73 [1.14-2.63]), diagnostic delay ≥ 3 years (HR, 1.63 [1.01-2.65]), aortic regurgitation (HR, 1.61 [1.01-2.56]), and age at diagnosis (HR, 1.05 [1.02-1.07]) independently increased cardiovascular events and were included in the final model. The optimism-corrected C-index and Brier score of prediction model were 0.71 (0.66-0.76) and 0.072, respectively, and the calibration plots suggested good agreement between the observed and predicted probability of cardiovascular events.
CONCLUSIONS: Patients with TAK were at high risk of cardiovascular events. Advanced age at diagnosis, diagnosis delayed over 3 years, pulselessness, pulmonary hypertension, aortic regurgitation, and elevated ESR at disease onset were risk factors for cardiovascular events.
CLINICAL TRIAL REGISTRATION: JS-2038.