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GCA and the Risk of Cerebrovascular Ischemic Events

Cerebrovascular ischemic events (CIE) can be one of the most severe complications of giant cell arteritis (GCA), but is seen in 4-5% of GCA patients according to a recent French University Hospital. 

A retrospective study of 271 GCA patients (89 males, mean age 72 ± 9 years) from the Lille University Hospital were included and met the American College of Rheumatology (ACR) diagnostic criteria for GCA. They calculated the pooled summary estimate of GCA-related CIE prevalence.

From a total of 271 GCA patients:

  • 14 patients (5.2%) presented with GCA-related CIE
  • 8 vertebrobasilar, 5 carotid , and 1 with multifocal ischemic and hemorrhagic strokes related to intra-cranial vasculitis.

These 14 patients were included in a meta-analysis of 3553 GCA patients, that showed a pooled prevalence of GCA-related CIE was 4%.

Predictors of GCA-related CIE from the french population included:

  • lower body mass index (BMI)
  • vertebral artery thrombosis on Doppler US (17% vs 0.8%, p = 0.012)
  • vertebral arteries involvement (50% vs 3.4%, p < 0.001)
  • intracranial arteries involvement (50% vs 1.8%, p < 0.001) on CT angiography and/or MRA
  • axillary arteries involvement on PET/CT (55% vs 20%, p = 0.016).

The pooled prevalence of GCA-related CIE was low at 4% and associated with lower BMI, vertebral/intracranial, and extracranial involvement.


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The author has no conflicts of interest to disclose related to this subject