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Increased Mortality Due to Cardiovascular Disease in Patients with Giant Cell Arteritis in Northern Sweden AGNETA UDDHAMMAR, ANNA-LENA ERIKSSON, LENNARTH NYSTRÖM, ROGER STENLING, and SOLBRITT RANTAPÄÄ-DAHLQVIST
ABSTRACT. Methods. Patients with biopsy proven GCA or with PMR, whose condition was diagnosed between 1973 and 1979, were followed until December 31, 1995. The standardized mortality ratio (SMR) was estimated using data for the population of Västerbotten, Northern Sweden, as reference value. Information for sex, age at diagnosis, erythrocyte sedimentation rate (ESR) at diagnosis, corticosteroid therapy, comorbidity from diagnosis, and date and cause of death was collected. Results. A total of 136 patients with GCA and 35 with PMR were identified. At the time of followup 114 patients with GCA and 25 with PMR were deceased. The overall mortality was significantly increased in the female patients, SMR = 133 (95% CI 110-162). Death due to cardiovascular disease (CVD) was significantly increased in both women and men, SMR = 149 (95% CI 118-189) and 158 (95% CI 112-224), respectively, and mainly due to ischemic heart disease. An excess mortality was found in women with the highest ESR, the highest prescribed dose of prednisolone at diagnosis, or a daily prednisolone dose of 10 mg or more one year after diagnosis. In multiple Cox regression analysis, male sex and hypertension significantly increased the risk of a CVE. Conclusion. Death due to CVD was increased in patients with GCA. Increased mortality was related to either the corticosteroid therapy itself or insufficient control of inflammation. (J Rheumatol 2002;29:737-42) Key Indexing Terms:
GIANT CELL ARTERITIS
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