cardiovascular-agents and Giant-Cell-Arteritis

Giant cell arteritis (GCA) is increasingly being recognized as a systemic vascular disease, not confined to the cranial arteries. Epidemiological studies have shown that almost one-third of the patients with GCA develop serious peripheral vascular complications during long-term follow up, and there is growing evidence that unrecognized extracranial involvement may be even more common. GCA of large- and medium-sized peripheral arteries typically leads to long tapering and occlusion of the arterial lumen due to concentric intimal thickening, sometimes accompanied by spontaneous dissection. Depending on the extent of the arterial obliteration and on the anatomy of the involved arterial segment, this may result in severe ischemia of the limbs during the acute phase of the disease. GCA of the aorta usually remains asymptomatic for many years, and leads to a markedly increased risk of aneurysms and dissections, particularly of the thoracic aorta. Evolving vascular imaging techniques such as duplex ultrasound, computer tomography (CT), magnetic resonance imaging (MRI), and fluorine-18-desoxyglucose positron emission tomography (18F-FDG-PET) have greatly improved our ability to detect and study arterial changes in large-artery vasculitis. Boosted by these advances in vascular imaging, vascular specialists are increasingly involved in the early diagnosis, follow-up and treatment of patients with large-vessel vasculitis.

Topics: Angiography, Digital Subtraction; Arterial Occlusive Diseases; Biomarkers; Cardiovascular Agents; Fluorodeoxyglucose F18; Giant Cell Arteritis; Glucocorticoids; Humans; Inflammation Mediators; Magnetic Resonance Angiography; Peripheral Vascular Diseases; Physical Examination; Positron-Emission Tomography; Radiopharmaceuticals; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography, Doppler, Color; Vascular Surgical Procedures

Topics: Arteriosclerosis; Cardiovascular Agents; Cardiovascular Diseases; Embolism; Endocarditis, Bacterial; Eye Diseases; Giant Cell Arteritis; Humans; Medical History Taking; Ocular Hypertension; Retinal Vein Occlusion; Syndrome

To determine whether exposure to cardiovascular medications and statins is associated with increased risk of giant cell arteritis (GCA).. The population-based case-control study comprised a cohort of patients with biopsy-confirmed GCA linked to the Swedish Prescribed Drug Register to identify all exposure to drugs prior to diagnosis of GCA. Ten controls per GCA case, matched for age, sex and residential area, were included. Using corresponding Anatomical Therapeutic Chemical codes, ACE inhibitors, angiotensin II receptor blockers, beta-blocking agents, calcium antagonists, diuretics, statins and cardiac therapy drugs were investigated from July 1, 2005 to the diagnosis/index date. A conditional logistic regression model was fitted adjusted for income, education level and marital status. We repeated the analyses including only new drug users excluding those with any prescription during the year from July 1, 2005 to July 1, 2006.. 574 cases (29% men) of diagnosed GCA and 5740 controls (29% men) were included. The mean age at diagnosis is 75 years (SD 8). Of the GCA cases, 71% had at least one dispensation of a cardiovascular drug prior to the index date, compared to 74% of controls. The ORs for the association of target drug exposure with GCA were <1 for most drugs, but close to 1 in the analysis of new users. Statins were consistently associated with lower risk of GCA, OR 0.74 (95% CI 0.61 to 0.90).. Statins may be associated with lower risk of incident biopsy-confirmed GCA. No association was evident for other studied drugs.

Topics: Biopsy; Cardiovascular Agents; Case-Control Studies; Female; Giant Cell Arteritis; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Male; Risk Factors

Topics: Adult; Cardiovascular Agents; Female; Giant Cell Arteritis; Humans; Immunosuppressive Agents; Male; Polyarteritis Nodosa; Syndrome; Systemic Vasculitis; Takayasu Arteritis; Thromboangiitis Obliterans; Vasculitis

Topics: Cardiovascular Agents; Cerebral Palsy; Chorea; Ergot Alkaloids; Giant Cell Arteritis; Headache; Humans; Methysergide; Migraine Disorders; Oxytocics; Selective Serotonin Reuptake Inhibitors; Serotonin; Trigeminal Neuralgia