The effect of late diagnosis on survival and risk of vascular complications in Takayasu's arteritis patients

Aim. To assess the effect of late diagnosis on survival and risk of vascular complications in Takayasu's arteritis (TA) patients.  Methods. 183 patients with TA who were treated at the Sverdlovsk Regional Clinical Hospital No. 1 during the period from 01.01.1979 to 31.04.2018 were examined. The...

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Main Authors: I. E. Borodina, A. A. Popov, L. A. Shardina
Format: Article
Language:Russian
Published: IMA PRESS LLC 2021-12-01
Series:Научно-практическая ревматология
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Online Access:https://rsp.mediar-press.net/rsp/article/view/3100
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author I. E. Borodina
A. A. Popov
L. A. Shardina
author_facet I. E. Borodina
A. A. Popov
L. A. Shardina
author_sort I. E. Borodina
collection DOAJ
description Aim. To assess the effect of late diagnosis on survival and risk of vascular complications in Takayasu's arteritis (TA) patients.  Methods. 183 patients with TA who were treated at the Sverdlovsk Regional Clinical Hospital No. 1 during the period from 01.01.1979 to 31.04.2018 were examined. There were 139 women and 44 men included, median age at the time of diagnosis being 35 [24; 44] years in females and 34 [26.5; 42] years in males and a median interval from the first symptoms onset to the diagnosis of 3 [1; 7] and 4 [1.5; 8] years respectively. The diagnosis of TA met the ACR criteria (1990).Results. During the follow-up period, 31 deaths were observed (18 in males and 13 in females). The median age of death for women was 36 [32-44] years, for men - 50 [40-57] years. Cardiovascular complications were recorded in 72 patients (27 men and 45 women). Vascular complications and namely acute cerebrovascular accident observed in 31 (43%) patients, including ischemic stroke in 24 (35%), transient ischemic attack in 3 (3%) and hemorrhagic stroke in 4 (6%) were the most frequent. Arterial thromboses were registered in 32 (44%) cases. In 162 (88.5%) patients, the diagnosis was established more than six months after the appearance of the first symptoms.At the primary physician visit in 71 (39%) patients, the initial diagnosis was erroneous. The most common symptoms they had were regarded as a manifestation of arterial hypertension (in 18% cases). 4 years or more interval from the onset of TA symptoms to diagnosis was associated with a significant cardiovascular events odds increase (OR=1.8; 95% CI: 1.07-3.34) and premature death by the 5th year of follow-up (OR=2.9; 95% CI: 1,27-6,55).Conclusion. In the retrospective TA cohort setting, late diagnosis verification and delayed treatment initiation were associated with an increased risk of premature death and severe vascular complications, described earlier in other samplings. Timely diagnosis and as early as possible appropriate treatment administration can prevent the disease progression and disabling complications occurrence.
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spelling doaj-art-645869c3f2b74c4195239bfbb20a0b512025-08-04T17:04:01ZrusIMA PRESS LLCНаучно-практическая ревматология1995-44841995-44922021-12-0159672072610.47360/1995-4484-2021-720-7262764The effect of late diagnosis on survival and risk of vascular complications in Takayasu's arteritis patientsI. E. Borodina0A. A. Popov1L. A. Shardina2Sverdlovsk Regional Clinical Hospital No. 1; Ural State Medical UniversityUral State Medical UniversityUral State Medical UniversityAim. To assess the effect of late diagnosis on survival and risk of vascular complications in Takayasu's arteritis (TA) patients.  Methods. 183 patients with TA who were treated at the Sverdlovsk Regional Clinical Hospital No. 1 during the period from 01.01.1979 to 31.04.2018 were examined. There were 139 women and 44 men included, median age at the time of diagnosis being 35 [24; 44] years in females and 34 [26.5; 42] years in males and a median interval from the first symptoms onset to the diagnosis of 3 [1; 7] and 4 [1.5; 8] years respectively. The diagnosis of TA met the ACR criteria (1990).Results. During the follow-up period, 31 deaths were observed (18 in males and 13 in females). The median age of death for women was 36 [32-44] years, for men - 50 [40-57] years. Cardiovascular complications were recorded in 72 patients (27 men and 45 women). Vascular complications and namely acute cerebrovascular accident observed in 31 (43%) patients, including ischemic stroke in 24 (35%), transient ischemic attack in 3 (3%) and hemorrhagic stroke in 4 (6%) were the most frequent. Arterial thromboses were registered in 32 (44%) cases. In 162 (88.5%) patients, the diagnosis was established more than six months after the appearance of the first symptoms.At the primary physician visit in 71 (39%) patients, the initial diagnosis was erroneous. The most common symptoms they had were regarded as a manifestation of arterial hypertension (in 18% cases). 4 years or more interval from the onset of TA symptoms to diagnosis was associated with a significant cardiovascular events odds increase (OR=1.8; 95% CI: 1.07-3.34) and premature death by the 5th year of follow-up (OR=2.9; 95% CI: 1,27-6,55).Conclusion. In the retrospective TA cohort setting, late diagnosis verification and delayed treatment initiation were associated with an increased risk of premature death and severe vascular complications, described earlier in other samplings. Timely diagnosis and as early as possible appropriate treatment administration can prevent the disease progression and disabling complications occurrence.https://rsp.mediar-press.net/rsp/article/view/3100late diagnosistakayasu's arteritis
spellingShingle I. E. Borodina
A. A. Popov
L. A. Shardina
The effect of late diagnosis on survival and risk of vascular complications in Takayasu's arteritis patients
Научно-практическая ревматология
late diagnosis
takayasu's arteritis
title The effect of late diagnosis on survival and risk of vascular complications in Takayasu's arteritis patients
title_full The effect of late diagnosis on survival and risk of vascular complications in Takayasu's arteritis patients
title_fullStr The effect of late diagnosis on survival and risk of vascular complications in Takayasu's arteritis patients
title_full_unstemmed The effect of late diagnosis on survival and risk of vascular complications in Takayasu's arteritis patients
title_short The effect of late diagnosis on survival and risk of vascular complications in Takayasu's arteritis patients
title_sort effect of late diagnosis on survival and risk of vascular complications in takayasu s arteritis patients
topic late diagnosis
takayasu's arteritis
url https://rsp.mediar-press.net/rsp/article/view/3100
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