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Impact of Cardiovascular Risk Factors on the Occurrence of Cardiovascular Events in Antineutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitides

Author

J Clin Med. 2021 May 25;10(11):2299. doi: 10.3390/jcm10112299.

Camille Roubille 1 2Soledad Henriquez 3 4Cédric Mercuzot 1Claire Duflos 5Bertrand Dunogue 3 4Karine Briot 4 6Loic Guillevin 3 4Benjamin Terrier 3 4Pierre Fesler 1 2

Author Information

1 Department of Internal Medicine, Lapeyronie Hospital, Montpellier University Hospital, 34000 Montpellier, France.

2 PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, 34000 Montpellier, France.

3 Department of Internal Medicine, Assistance Publique Hôpitaux de Paris-Centre, Université de Paris, Hôpital Cochin, 75014 Paris, France.

4 Université de Paris, 75006 Paris, France.

 5 Clinical Research and Epidemiology Unit, Medical Information Department, Lapeyronie Hospital, Montpellier University Hospital, 34000 Montpellier, France.

6 Department of Rheumatology, Assistance Publique Hôpitaux de Paris-Centre, Université de Paris, Hôpital Cochin, 75014 Paris, France.

Abstract

Despite improvement in the prognosis of ANCA-associated vasculitides (AAVs), increased mortality, mainly from a cardiovascular origin, persists. We aimed to determine the role of cardiovascular risk factors (CVRFs) on the occurrence of major cardiovascular events (MACEs) in AAVs. Patients with AAVs were successively included in a prospective cohort study, which assessed CVRFs (defined by age >50 years in men and >60 years in women, personal history of cardiovascular disease, smoking status, obesity, diabetes, dyslipidemia, hypertension, and sedentary lifestyle), the use of glucocorticoids and immunosuppressive agents at baseline and during follow-up, and the occurrence of MACEs. One hundred and three patients were included, with a median follow-up time of 3.5 years. In the glucocorticoids and cyclophosphamide adjusted multivariate analysis, the occurrence of MACEs was associated with older age (p = 0.001, OR = 14.71, 95% CI (confidence interval) = 2.98-72.68), cardiovascular history (p = 0.007, OR (odds ratio) = 6.54, 95% CI = 1.66-25.71), sedentary lifestyle (p = 0.011, OR = 4.50, 95% CI = 1.42-14.29), hypertension (p = 0.017, OR = 5.04, 95% CI = 1.33-19.12), and dyslipidemia (p = 0.03, OR = 3.86, 95% CI = 1.14-13.09). The occurrence of MACEs was associated with the number of CVRFs (p < 0.001), but not with the use of glucocorticoids or cyclophosphamide (p = 0.733 and p = 0.339, respectively). The implementation of a screening and management program for modifiable CVRFs, particularly hypertension, sedentary lifestyle, and dyslipidemia, may be beneficial for AAV patients in order to reduce their cardiovascular risk.