Long-term cardiovascular outcomes and temporal trends in patients diagnosed with ANCA-associated vasculitis: a Danish nationwide registry study
To examine long-term cardiovascular outcomes and temporal trends among patients with ANCA-associated vasculitis (AAV) using Danish nationwide registries. Using a cohort design, we examined patients with granulomatosis with polyangiitis (ICD-10: DM31.3) and microscopic polyangiitis (ICD-10: DM3.17) i...
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| Veröffentlicht in: | Rheumatology (Oxford, England) England), 2023-02, Vol.62 (2), p.735-746 |
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| creator | Nygaard, Louis Polcwiartek, Christoffer Nelveg-Kristensen, Karl Emil Carlson, Nicholas Kristensen, Salome Torp-Pedersen, Christian Gregersen, Jon Waarst |
| description | To examine long-term cardiovascular outcomes and temporal trends among patients with ANCA-associated vasculitis (AAV) using Danish nationwide registries.
Using a cohort design, we examined patients with granulomatosis with polyangiitis (ICD-10: DM31.3) and microscopic polyangiitis (ICD-10: DM3.17) in Denmark from 1996-2018. Hazard ratios (HRs) of cardiovascular outcomes were compared between patients with AAV and age and gender-matched controls. Counterfactual G-estimation of HRs was performed to estimate 5-year absolute risks. Temporal trends were obtained by grouping cohorts into evenly distributed tertiles according to inclusion year.
A total of 2306 patients with AAV (median age: 62.9yrs, 52.6% male) were matched with 6918 controls. Median follow-up was 9.5yrs. Patients with AAV had a higher rate of ischaemic heart disease [HR 1.86 (1.62-2.15)], myocardial infarction [HR 1.62 (1.26-2.09)], coronary angiogram [HR 1.64 (1.37-1.96)], percutaneous coronary intervention [HR 1.56 (1.17-2.07)] and ventricular arrhythmias/implantable-cardioverter-defibrillator (ICD)-implantations [HR 2.04 (1.16-3.57)]. Similarly, an increased rate of heart failure [HR 2.12 (1.77-2.54)], deep vein thrombosis [HR 3.13 (2.43-4.05)], pulmonary embolism [HR 4.04 (3.07-5.32)], atrial fibrillation [HR 2.08 (1.82-2.39)], ischaemic stroke [HR 1.58 (1.31-1.90)] and in-hospital cardiac arrest [HR 2.27 (1.49-3.48)] was observed. The 5-year risk of all outcomes were significantly higher (excluding ventricular arrhythmia/ICD-implantations). For temporal trends among patients with AAV, a decreased 3-year risk of cardiovascular mortality was observed over time.
Patients with AAV are at increased risk of heart failure, atrial-/ventricular arrhythmias, venous thrombotic events, ischaemic stroke and myocardial infarction. Furthermore, patients with AAV were more frequently examined with coronary procedures and underwent more coronary revascularizations. No temporal changes in ischaemic cardiovascular outcomes were observed, albeit the cardiovascular mortality has decreased over time. |
| doi_str_mv | 10.1093/rheumatology/keac386 |
| format | Article |
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Using a cohort design, we examined patients with granulomatosis with polyangiitis (ICD-10: DM31.3) and microscopic polyangiitis (ICD-10: DM3.17) in Denmark from 1996-2018. Hazard ratios (HRs) of cardiovascular outcomes were compared between patients with AAV and age and gender-matched controls. Counterfactual G-estimation of HRs was performed to estimate 5-year absolute risks. Temporal trends were obtained by grouping cohorts into evenly distributed tertiles according to inclusion year.
A total of 2306 patients with AAV (median age: 62.9yrs, 52.6% male) were matched with 6918 controls. Median follow-up was 9.5yrs. Patients with AAV had a higher rate of ischaemic heart disease [HR 1.86 (1.62-2.15)], myocardial infarction [HR 1.62 (1.26-2.09)], coronary angiogram [HR 1.64 (1.37-1.96)], percutaneous coronary intervention [HR 1.56 (1.17-2.07)] and ventricular arrhythmias/implantable-cardioverter-defibrillator (ICD)-implantations [HR 2.04 (1.16-3.57)]. Similarly, an increased rate of heart failure [HR 2.12 (1.77-2.54)], deep vein thrombosis [HR 3.13 (2.43-4.05)], pulmonary embolism [HR 4.04 (3.07-5.32)], atrial fibrillation [HR 2.08 (1.82-2.39)], ischaemic stroke [HR 1.58 (1.31-1.90)] and in-hospital cardiac arrest [HR 2.27 (1.49-3.48)] was observed. The 5-year risk of all outcomes were significantly higher (excluding ventricular arrhythmia/ICD-implantations). For temporal trends among patients with AAV, a decreased 3-year risk of cardiovascular mortality was observed over time.
Patients with AAV are at increased risk of heart failure, atrial-/ventricular arrhythmias, venous thrombotic events, ischaemic stroke and myocardial infarction. Furthermore, patients with AAV were more frequently examined with coronary procedures and underwent more coronary revascularizations. No temporal changes in ischaemic cardiovascular outcomes were observed, albeit the cardiovascular mortality has decreased over time.</description><identifier>ISSN: 1462-0324</identifier><identifier>EISSN: 1462-0332</identifier><identifier>DOI: 10.1093/rheumatology/keac386</identifier><identifier>PMID: 35788270</identifier><language>eng</language><publisher>England</publisher><subject>Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - complications ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - epidemiology ; Brain Ischemia - complications ; Denmark - epidemiology ; Female ; Heart Failure ; Humans ; Ischemic Stroke ; Male ; Middle Aged ; Myocardial Infarction - complications ; Myocardial Infarction - epidemiology ; Registries ; Risk Factors ; Stroke</subject><ispartof>Rheumatology (Oxford, England), 2023-02, Vol.62 (2), p.735-746</ispartof><rights>The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c307t-f820da877eb6b44ccf8692ff90432355cf5efda60c9f977a9a6a138fe71726193</citedby><cites>FETCH-LOGICAL-c307t-f820da877eb6b44ccf8692ff90432355cf5efda60c9f977a9a6a138fe71726193</cites><orcidid>0000-0003-1943-0097 ; 0000-0001-5812-5234 ; 0000-0002-2967-4848 ; 0000-0003-2892-6131 ; 0000-0002-4374-470X ; 0000-0001-9372-7484</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35788270$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nygaard, Louis</creatorcontrib><creatorcontrib>Polcwiartek, Christoffer</creatorcontrib><creatorcontrib>Nelveg-Kristensen, Karl Emil</creatorcontrib><creatorcontrib>Carlson, Nicholas</creatorcontrib><creatorcontrib>Kristensen, Salome</creatorcontrib><creatorcontrib>Torp-Pedersen, Christian</creatorcontrib><creatorcontrib>Gregersen, Jon Waarst</creatorcontrib><title>Long-term cardiovascular outcomes and temporal trends in patients diagnosed with ANCA-associated vasculitis: a Danish nationwide registry study</title><title>Rheumatology (Oxford, England)</title><addtitle>Rheumatology (Oxford)</addtitle><description>To examine long-term cardiovascular outcomes and temporal trends among patients with ANCA-associated vasculitis (AAV) using Danish nationwide registries.
Using a cohort design, we examined patients with granulomatosis with polyangiitis (ICD-10: DM31.3) and microscopic polyangiitis (ICD-10: DM3.17) in Denmark from 1996-2018. Hazard ratios (HRs) of cardiovascular outcomes were compared between patients with AAV and age and gender-matched controls. Counterfactual G-estimation of HRs was performed to estimate 5-year absolute risks. Temporal trends were obtained by grouping cohorts into evenly distributed tertiles according to inclusion year.
A total of 2306 patients with AAV (median age: 62.9yrs, 52.6% male) were matched with 6918 controls. Median follow-up was 9.5yrs. Patients with AAV had a higher rate of ischaemic heart disease [HR 1.86 (1.62-2.15)], myocardial infarction [HR 1.62 (1.26-2.09)], coronary angiogram [HR 1.64 (1.37-1.96)], percutaneous coronary intervention [HR 1.56 (1.17-2.07)] and ventricular arrhythmias/implantable-cardioverter-defibrillator (ICD)-implantations [HR 2.04 (1.16-3.57)]. Similarly, an increased rate of heart failure [HR 2.12 (1.77-2.54)], deep vein thrombosis [HR 3.13 (2.43-4.05)], pulmonary embolism [HR 4.04 (3.07-5.32)], atrial fibrillation [HR 2.08 (1.82-2.39)], ischaemic stroke [HR 1.58 (1.31-1.90)] and in-hospital cardiac arrest [HR 2.27 (1.49-3.48)] was observed. The 5-year risk of all outcomes were significantly higher (excluding ventricular arrhythmia/ICD-implantations). For temporal trends among patients with AAV, a decreased 3-year risk of cardiovascular mortality was observed over time.
Patients with AAV are at increased risk of heart failure, atrial-/ventricular arrhythmias, venous thrombotic events, ischaemic stroke and myocardial infarction. Furthermore, patients with AAV were more frequently examined with coronary procedures and underwent more coronary revascularizations. No temporal changes in ischaemic cardiovascular outcomes were observed, albeit the cardiovascular mortality has decreased over time.</description><subject>Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - complications</subject><subject>Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - epidemiology</subject><subject>Brain Ischemia - complications</subject><subject>Denmark - epidemiology</subject><subject>Female</subject><subject>Heart Failure</subject><subject>Humans</subject><subject>Ischemic Stroke</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - complications</subject><subject>Myocardial Infarction - epidemiology</subject><subject>Registries</subject><subject>Risk Factors</subject><subject>Stroke</subject><issn>1462-0324</issn><issn>1462-0332</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkcFu1DAQhi0EoqXwBgj5yCXUsRM74bbatoC0ohc4R7P2eNeQ2IvHodqn6CsTtEvFaUaj__9HMx9jb2vxoRa9us57nCcoaUy74_VPBKs6_Yxd1o2WlVBKPn_qZXPBXhH9EEK0tepesgvVmq6TRlyyx02Ku6pgnriF7EL6DWTnETJPc7FpQuIQHS84HVKGkZeM0REPkR-gBIyFuAuwi4nQ8YdQ9nz1db2qgCjZAGUZngJDCfSRA7-BGGjP42JO8SE45Bl3gUo-ciqzO75mLzyMhG_O9Yp9v7v9tv5cbe4_fVmvNpVVwpTKd1I46IzBrd42jbW-0730vheNkqptrW_RO9DC9r43BnrQsJzu0dRG6rpXV-z9KfeQ068ZqQxTIIvjCBHTTIPUXSuUNkos0uYktTkRZfTDIYcJ8nGoxfAXxfA_iuGMYrG9O2-YtxO6J9O_36s_JQaOFw</recordid><startdate>20230201</startdate><enddate>20230201</enddate><creator>Nygaard, Louis</creator><creator>Polcwiartek, Christoffer</creator><creator>Nelveg-Kristensen, Karl Emil</creator><creator>Carlson, Nicholas</creator><creator>Kristensen, Salome</creator><creator>Torp-Pedersen, Christian</creator><creator>Gregersen, Jon Waarst</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1943-0097</orcidid><orcidid>https://orcid.org/0000-0001-5812-5234</orcidid><orcidid>https://orcid.org/0000-0002-2967-4848</orcidid><orcidid>https://orcid.org/0000-0003-2892-6131</orcidid><orcidid>https://orcid.org/0000-0002-4374-470X</orcidid><orcidid>https://orcid.org/0000-0001-9372-7484</orcidid></search><sort><creationdate>20230201</creationdate><title>Long-term cardiovascular outcomes and temporal trends in patients diagnosed with ANCA-associated vasculitis: a Danish nationwide registry study</title><author>Nygaard, Louis ; Polcwiartek, Christoffer ; Nelveg-Kristensen, Karl Emil ; Carlson, Nicholas ; Kristensen, Salome ; Torp-Pedersen, Christian ; Gregersen, Jon Waarst</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c307t-f820da877eb6b44ccf8692ff90432355cf5efda60c9f977a9a6a138fe71726193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - complications</topic><topic>Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - epidemiology</topic><topic>Brain Ischemia - complications</topic><topic>Denmark - epidemiology</topic><topic>Female</topic><topic>Heart Failure</topic><topic>Humans</topic><topic>Ischemic Stroke</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - complications</topic><topic>Myocardial Infarction - epidemiology</topic><topic>Registries</topic><topic>Risk Factors</topic><topic>Stroke</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nygaard, Louis</creatorcontrib><creatorcontrib>Polcwiartek, Christoffer</creatorcontrib><creatorcontrib>Nelveg-Kristensen, Karl Emil</creatorcontrib><creatorcontrib>Carlson, Nicholas</creatorcontrib><creatorcontrib>Kristensen, Salome</creatorcontrib><creatorcontrib>Torp-Pedersen, Christian</creatorcontrib><creatorcontrib>Gregersen, Jon Waarst</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Rheumatology (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nygaard, Louis</au><au>Polcwiartek, Christoffer</au><au>Nelveg-Kristensen, Karl Emil</au><au>Carlson, Nicholas</au><au>Kristensen, Salome</au><au>Torp-Pedersen, Christian</au><au>Gregersen, Jon Waarst</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term cardiovascular outcomes and temporal trends in patients diagnosed with ANCA-associated vasculitis: a Danish nationwide registry study</atitle><jtitle>Rheumatology (Oxford, England)</jtitle><addtitle>Rheumatology (Oxford)</addtitle><date>2023-02-01</date><risdate>2023</risdate><volume>62</volume><issue>2</issue><spage>735</spage><epage>746</epage><pages>735-746</pages><issn>1462-0324</issn><eissn>1462-0332</eissn><abstract>To examine long-term cardiovascular outcomes and temporal trends among patients with ANCA-associated vasculitis (AAV) using Danish nationwide registries.
Using a cohort design, we examined patients with granulomatosis with polyangiitis (ICD-10: DM31.3) and microscopic polyangiitis (ICD-10: DM3.17) in Denmark from 1996-2018. Hazard ratios (HRs) of cardiovascular outcomes were compared between patients with AAV and age and gender-matched controls. Counterfactual G-estimation of HRs was performed to estimate 5-year absolute risks. Temporal trends were obtained by grouping cohorts into evenly distributed tertiles according to inclusion year.
A total of 2306 patients with AAV (median age: 62.9yrs, 52.6% male) were matched with 6918 controls. Median follow-up was 9.5yrs. Patients with AAV had a higher rate of ischaemic heart disease [HR 1.86 (1.62-2.15)], myocardial infarction [HR 1.62 (1.26-2.09)], coronary angiogram [HR 1.64 (1.37-1.96)], percutaneous coronary intervention [HR 1.56 (1.17-2.07)] and ventricular arrhythmias/implantable-cardioverter-defibrillator (ICD)-implantations [HR 2.04 (1.16-3.57)]. Similarly, an increased rate of heart failure [HR 2.12 (1.77-2.54)], deep vein thrombosis [HR 3.13 (2.43-4.05)], pulmonary embolism [HR 4.04 (3.07-5.32)], atrial fibrillation [HR 2.08 (1.82-2.39)], ischaemic stroke [HR 1.58 (1.31-1.90)] and in-hospital cardiac arrest [HR 2.27 (1.49-3.48)] was observed. The 5-year risk of all outcomes were significantly higher (excluding ventricular arrhythmia/ICD-implantations). For temporal trends among patients with AAV, a decreased 3-year risk of cardiovascular mortality was observed over time.
Patients with AAV are at increased risk of heart failure, atrial-/ventricular arrhythmias, venous thrombotic events, ischaemic stroke and myocardial infarction. Furthermore, patients with AAV were more frequently examined with coronary procedures and underwent more coronary revascularizations. No temporal changes in ischaemic cardiovascular outcomes were observed, albeit the cardiovascular mortality has decreased over time.</abstract><cop>England</cop><pmid>35788270</pmid><doi>10.1093/rheumatology/keac386</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-1943-0097</orcidid><orcidid>https://orcid.org/0000-0001-5812-5234</orcidid><orcidid>https://orcid.org/0000-0002-2967-4848</orcidid><orcidid>https://orcid.org/0000-0003-2892-6131</orcidid><orcidid>https://orcid.org/0000-0002-4374-470X</orcidid><orcidid>https://orcid.org/0000-0001-9372-7484</orcidid></addata></record> |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - complications Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - epidemiology Brain Ischemia - complications Denmark - epidemiology Female Heart Failure Humans Ischemic Stroke Male Middle Aged Myocardial Infarction - complications Myocardial Infarction - epidemiology Registries Risk Factors Stroke |
| title | Long-term cardiovascular outcomes and temporal trends in patients diagnosed with ANCA-associated vasculitis: a Danish nationwide registry study |
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