TOPLINE

Patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) faced an increased risk for cardiovascular disease and thromboembolism (CVD-TE) compared with matched control individuals. Sex-specific differences emerged in patients with granulomatosis with polyangiitis (GPA), where men had an increased risk for myocardial infarction (MI), whereas women had an elevated risk for ischemic stroke.

METHODOLOGY

• AAV are systemic autoimmune disorders that comprise GPA, microscopic polyangiitis (MPA), and eosinophilic GPA.
• Researchers conducted a population-based matched cohort study in Sweden using data from national healthcare registers from 2005 to 2020, examining the risk for CVD-TE in adults diagnosed with GPA or MPA.
• A total of 4317 patients with AAV (median age, 67 years; 50% men) were matched with 21,582 control individuals, and 25,568 first-degree siblings of both patients and control individuals were included to assess familial risk factors.
• Among patients with AAV, 73% were diagnosed with GPA and 27% were diagnosed with MPA.
• The outcomes of interest were MI, ischemic or hemorrhagic stroke, deep vein thrombosis (DVT), and pulmonary embolism (PE); death due to these outcomes was defined as CVD-TE-related death.

TAKEAWAY

• Both patients with GPA and those with MPA had an increased risk for CVD-TE compared with control individuals (hazard ratio [HR], 2.04; 95% CI, 1.83-2.28 and HR, 2.45; 95% CI, 2.00-2.99, respectively), with no significant differences between the two AAV subtypes for the risk for individual outcomes.
• Both sexes demonstrated an increased risk for DVT and PE, but sex-specific patterns emerged in patients with GPA: only men had an elevated risk for MI (HR, 2.25; 95% CI, 1.74-2.92), whereas only women had an increased risk for ischemic stroke (HR, 1.64; 95% CI, 1.25-2.17) and CVD-TE-related death (HR, 1.72; 95% CI, 1.13-2.61).
• In patients with MPA, the risk for ischemic stroke was not increased among men or women. Increased risks for MI (HR, 2.32; 95% CI, 1.27-4.25) and CVD-TE-related death (HR, 2.09; 95% CI, 1.06-4.12) were observed in men.
• Patients with GPA (HR, 2.45; 95% CI, 1.99-3.01) and those with MPA (HR, 3.16; 95% CI, 2.13-4.68) had overall increased risks for CVD-TE compared with their siblings. Siblings of patients with AAV showed no excess risk for any CVD-TE compared with siblings of matched control individuals.

IN PRACTICE

"[The] study highlights the importance of timely diagnosis and increased surveillance of both cardiovascular and thromboembolic events in patients with AAV," the authors wrote.

SOURCE

The study was led by Hanna Lindberg, Department of Medical Sciences, Rheumatology, Uppsala University, Uppsala, Sweden. It was published online on September 4 in Rheumatology.

LIMITATIONS

The observational nature of the study meant that no conclusions could be drawn about cause and effect. The study relied on diagnostic codes for AAV diagnoses, which may have resulted in misclassification. The analysis could not account for disease activity, medications, or other clinical variables.

DISCLOSURES

This project was funded by the Swedish Stroke Foundation, the Swedish Rheumatism Association, the Agnes and Mac Rudberg Foundation, Åke Wiberg's Foundation, and other sources. The authors reported no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.