Risk of acute arterial and venous thromboembolic events in eosinophilic granulomatosis with polyangiitis (Churg–Strauss syndrome)
Year: 2021
Type: article
Abstract: ABSTRACT Background and objective Systemic small vessel vasculitides carry an increased risk of acute arterial and venous thromboembolic events (AVTE); however, this risk has not been systematically explored in Eosinophilic Granulomatosis with Polyangiitis (EGPA). This study assessed the occurrence and main risk factors of AVTE among EGPA patients as compared to the general community from the population-based Bruneck cohort. Methods We conducted a retrospective multicenter cohort study on 573 EGPA patients. Clinical and serological data were collected at diagnosis. Occurrence of AVTE and time to the first AVTE after EGPA diagnosis were recorded. Age-standardized event rate (SER) of AVTE as compared to the reference cohort was assessed. Cox regression was applied to identify AVTE predictors. Results 129 EGPA patients (22.5%) had AVTE, considered as potentially life-threatening in 55.8%. Seventy patients experienced an AVTE prior to diagnosis (of whom 58.6% in the two years before diagnosis) and 75 following EGPA diagnosis, of whom 56% in the two subsequent years. The SER of AVTE as compared to the reference cohort was 2.10 (95% CI 1.67-2.63). This risk was particularly increased in patients with history of AVTE and with a Birmingham Vasculitis Activity Score ≥20 at diagnosis. Patients receiving immunosuppression within 2 months of diagnosis were at lower risk, while antiplatelet or anticoagulant treatment did not confer measurable benefit. Conclusion EGPA is associated with AVTE in approximately one quarter of patients, particularly around diagnosis. Immunosuppressants seemed to exert a protective effect, while anticoagulant and antiplatelet agents did not.
Source: European Respiratory Journal
Authors: Alessandra Bettiol, Renato Alberto Sinico, Franco Schiavon, Sara Monti, Enrica Paola Bozzolo, Franco Franceschini, Marcello Govoni, Claudio Lunardi, Giuseppe Guida, Giuseppe Lopalco, Giuseppe Paolazzi, Angelo Vacca, Gina Gregorini, Pietro Leccese, Matteo Piga, Fabrizio Conti, Paolo Fraticelli, Luca Quartuccio, Federico Alberici, Carlo Salvarani, Silvano Bettio, Simone Negrini, Carlo Selmi, Savino Sciascia, Gabriella Moroni, Loredana Colla, Carlo Manno, Maria Letizia Urban, Alfredo Vannacci, Maria Rosa Pozzi, Paolo Fabbrini, Stefano Polti, Mara Felicetti, Maria Rita Marchi, Roberto Padoan, Paolo Delvino, Roberto Caporali, Carlomaurizio Montecucco, Lorenzo Dagna, Adriana Cariddi, Paola Toniati, Silvia Tamanini, Federica Furini, Alessandra Bortoluzzi, Elisa Tinazzi, Lorenzo Delfino, Iuliana Badiu, Giovanni Rolla, Vincenzo Venerito, Florenzo Iannone, Alvise Berti, Roberto Bortolotti, Vito Racanelli, Guido Jeannin, Angela Padula, Alberto Cauli, Roberta Priori, Armando Gabrielli, Milena Bond, Martina Tedesco, Giulia Pazzola, Paola Tomietto, Marco Pellecchio, Chiara Marvisi, Federica Maritati, Alessandra Palmisano, Christian Dejaco, Johann Willeit, Stefan Kiechl, Iacopo Olivotto, Peter Willeit, Domenico Prisco, Augusto Vaglio, Giacomo Emmi
Institutions: University of Florence, University of Milano-Bicocca, University of Padua, Azienda Ospedale - Università Padova, University of Pavia, Policlinico San Matteo Fondazione, IRCCS Ospedale San Raffaele, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, University of Ferrara, Arcispedale Sant'Anna, University of Verona, Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo, University of Bari Aldo Moro, Ospedale Santa Chiara, Ospedale San Carlo, University of Cagliari, Sapienza University of Rome, Azienda Ospedaliero-Universitaria delle Marche, University of Udine, University of Brescia, University of Modena and Reggio Emilia, Ospedale di Cattinara, Ospedale Policlinico San Martino, University of Genoa, Humanitas University, IRCCS Humanitas Research Hospital, Ospedale San Giovanni Bosco, University of Turin, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, Azienda Ospedaliera San Gerardo, University of Milan, Istituto Ortopedico Gaetano Pini, Vita-Salute San Raffaele University, A. O. Ordine Mauriziano di Torino, Marche Polytechnic University, Azienda Sanitaria Locale N. 2 Savonese, University of Parma, IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola, University of Bologna, Medical University of Graz, Azienda Sanitaria dell'Alto Adige, Innsbruck Medical University, Universität Innsbruck, Azienda Ospedaliero-Universitaria Careggi, University of Cambridge, Meyer Children's Hospital
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W3146294246