P1803 Incidence of venous thromboembolism in patients with granulomatosis with polyangiitis (Wegener"s granulomatosis)

Abstract Funding Acknowledgements none Background Granulomatosis with polyangiitis (GPA) is one of antineutrophil cytoplasmic autoantibody (ANCA) – associated vasculitis. This primary systemic vasculitis is multisystem disorder characterized by inflammation and necrosis of small and medium sized blood vessels. An increased risk of cardiovascular mortality and incidence of various cardiovascular events has been described among GPA patients. Purpose The aim of the present study was to assess the incidence of venous thromboembolism (VTE) and its correlation with echocardiographic parameters and laboratory findings in GPA patients. Methods The group of consecutive patients with GPA were followed in the study. In all patients echocardiography and laboratory tests were performed. Results One hundred four patients with GPA (mean age 51.6 ± 13.2 yrs) were followed for an average of 4,5 ± 1,9 years. In 24 patients venous thromboembolism was diagnosed during observation, however in majority of them (57%) VTE occurred during first year after diagnosis of GPA. There were no significant differences in creatinine, troponin T and CRP levels between patients with and without VTE. In patients with VTE there were larger right ventricle diameter (29.1 ± 4.4 vs. 32.1 ± 5.6; p = 0.04) and higher right ventricle systolic pressure (32.6 ± 5.4 vs. 37.3 ± 5.9; p = 0.02) observed. In this study group D-dimer was elevated in majority (56%) of patients. In patients with VTE D-dimer correlated positively with age (r = 0.5, p = 0.02), right ventricle diameter (r = 0.63, p = 0.001), right ventricle systolic pressure (r = 0.44, p = 0.04), and negatively with pulmonary artery acceleration time (r= -0.43, p = 0.05). Conclusions Venous thromboembolism is a common complication in patients with granulomatosis with polyangiitis, especially during first year after diagnosis. This finding is likely to be associated with changes in endothelial function and with induction of hypercoagulability resulting from changes in pro and anticoagulant factors associated with inflammation and its therapy.