Predictors of fatal and non-fatal cardiovascular events in ANCA-associated vasculitis: Data from the Toronto CanVasc cohort

Objectives: Patients with ANCA-associated vasculitis are at increased risk of cardiovascular events. The aim of the present study was to assess predictors of cardiovascular events in patients with granulomatosis with polyangiitis or eosinophilic granulomatosis with polyangiitis. Methods: This retrospective cohort study included patients from the Canadian Vasculitis ResearchNetwork cohort in Toronto. Characteristics at diagnosis were collected. During follow-up, non-fatal cardiovascular events were determined from the Vasculitis Damage Index; mortality and causes of deathwere recorded. Cox regression models were developed to determine predictors of cardiovascular events, defined as stroke or myocardial infarction. Results: A total of 336 patients were included (231 [69%] granulomatosis with polyangiitis; 105 [31%] eosinophilic granulomatosis with polyangiitis). The mean age at diagnosis was 44 (+/- 18) years and 44% were male. The incidence rate for the combined outcome of all fatal and non-fatal events was 7.2 eventsper 1000 patient-years. In a multivariate model, family history of cardiovascular events and a higherBirmingham Vasculitis Activity Score at diagnosis were predictive of cardiovascular events (hazard ratioand 95% confidence interval 3.46 [1.06-11.28] and 1.09 [1.02-1.16] respectively). In a subgroup analysisthere was no association between cardiovascular or disease-specific characteristics and cardiovascularevents in eosinophilic granulomatosis with polyangiitis. Conclusions: In this cohort of patients with granulomatosis with polyangiitis and eosinophilic granulomatosis with polyangiitis, both traditional and disease-related risk factors were predictive ofcardiovascular events. Further prospective studies should elucidate the impact of these and other modifiable risk factors on cardiovascular risk in ANCA-associated vasculitis. (c) 2020 Societe francaise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.