Hua Chen1,2, Yuehua Zhang1,2,3, Chaoran Li1,2, Wei Wu4, Jinjing Liu1,2, Fengchun Zhang1,2, Wenjie Zheng5,6. 1. Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China. 2. Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China. 3. Department of Oncology and Immunology, The fourth hospital of Hebei Medical University, Hebei, 050000, China. 4. Department of Cardiology, Peking Union Medical College Hospital, Beijing, China. 5. Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China. wenjzheng@gmail.com. 6. Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China. wenjzheng@gmail.com.
Abstract
OBJECTIVES: To investigate the clinical features and potential risk factors of coronary involvement in Behçet's disease (BD). METHOD: In this case-control study, we retrospectively reviewed medical records of BD patients admitted to our institute from 2000 to 2016. Coronary involvement was documented by coronary angiography and (or) computed tomography angiography. We analyzed the demographic, clinical, and laboratory data and compared with age- and gender-matched BD patients without coronary involvement. RESULTS: Among 476 BD patients (296 males) enrolled, 19 (4.0%) patients (17 males) were diagnosed with coronary involvement. The median duration from onset of BD to coronary involvement was 2.8 years. Coronary stenosis, aneurysm, and occlusion were presented in 13, 9, and 3 patients, respectively. Multiple coronary artery stenoses and aneurysms were observed in 9 and 3 patients, respectively. Smoking (36.8%) was the major traditional risk factors. Male gender (89.5% vs 61.1%, p = 0.01), skin lesions (78.9% vs 55.3%, p = 0.08), pathergy reactions (36.8% vs 10.5%, p = 0.01), extra-cardiac vasculitis (36.8% vs 6.6% p < 0.01), elevated ESR (57.9% vs 34.2%, p = 0.01), and elevated CRP (63.2% vs 42.1%, p < 0.01) were more common in BD patients with coronary involvement comparing with those without coronary involvement. Multivariate analysis confirmed pathergy reaction (OR = 3.81, 95% CI 1.08-13.47) was the independent risk factor. CONCLUSIONS: Coronary involvement in BD patients is rare and male-predominant and is characterized by the aneurysm and multivessel involvement. Elevated ESR and CRP are frequent, and the pathergy reaction is the independent risk factor. Key Points • Coronary involvement in BD patients is rare and male-predominant. • Pathergy reaction is the risk factor for coronary involvement in BD patients.
OBJECTIVES: To investigate the clinical features and potential risk factors of coronary involvement in Behçet's disease (BD). METHOD: In this case-control study, we retrospectively reviewed medical records of BDpatients admitted to our institute from 2000 to 2016. Coronary involvement was documented by coronary angiography and (or) computed tomography angiography. We analyzed the demographic, clinical, and laboratory data and compared with age- and gender-matched BDpatients without coronary involvement. RESULTS: Among 476 BDpatients (296 males) enrolled, 19 (4.0%) patients (17 males) were diagnosed with coronary involvement. The median duration from onset of BD to coronary involvement was 2.8 years. Coronary stenosis, aneurysm, and occlusion were presented in 13, 9, and 3 patients, respectively. Multiple coronary artery stenoses and aneurysms were observed in 9 and 3 patients, respectively. Smoking (36.8%) was the major traditional risk factors. Male gender (89.5% vs 61.1%, p = 0.01), skin lesions (78.9% vs 55.3%, p = 0.08), pathergy reactions (36.8% vs 10.5%, p = 0.01), extra-cardiac vasculitis (36.8% vs 6.6% p < 0.01), elevated ESR (57.9% vs 34.2%, p = 0.01), and elevated CRP (63.2% vs 42.1%, p < 0.01) were more common in BDpatients with coronary involvement comparing with those without coronary involvement. Multivariate analysis confirmed pathergy reaction (OR = 3.81, 95% CI 1.08-13.47) was the independent risk factor. CONCLUSIONS: Coronary involvement in BDpatients is rare and male-predominant and is characterized by the aneurysm and multivessel involvement. Elevated ESR and CRP are frequent, and the pathergy reaction is the independent risk factor. Key Points • Coronary involvement in BDpatients is rare and male-predominant. • Pathergy reaction is the risk factor for coronary involvement in BDpatients.
Authors: O Bletry; A Mohattane; B Wechsler; P Beaufils; P Valère; J Petit; R Gourgon; Y Grosgogeat; P Godeau Journal: Presse Med Date: 1988-12-17 Impact factor: 1.228