Predictive factors for cardiovascular involvement in behcet disease: A retrospective Tunisian cohort

Background and Aims: Cardiovascular involvement, also referred as angio Behçet Disease (BD), is frequent affecting veins and arteries as well as cardiac layers. We aimed in this work to describe clinical characteristics, predictive factors and management of angio BD in the Tunisian context Methods: We retrospectively studied 213 records of all BD patients followed between January 2004 and May 2016 in the Internal Medicine Department and who fulfilled the ISGBD criteria. We described first clinical features of BD with cardiovascular involvement then predictive factors were studied in univariate then multivariate analysis. Results: Among the 213 patients, 64 (30%) were diagnosed as having angio BD. The mean age at diagnosis was 31.5 years. About 81.25% of them were males and 18.75% females. Vascular involvement was found in 73 patients (34.27%). Deep venous thromboses are most common (62.5%) compared with superficial ones (23.4%), pulmonary arterial thrombosis (14.1%) or aneurysms (9.4%). Cardiac involvement can affect all layers ranging from pericarditis (1.6%) to intra cardiac thrombosis (3.1%) and myocardial infarction (1.6%). Predictive factors associated with cardiovascular involvement in BD are male gender (OR=3.043, 95% CI= 1.436- 6.447, p=0.004), erythema nodosum (OR= 4.134, 95% CI= 1.541- 11.091, p=0.005) and neurologic involvement (OR= 2.46, 95% CI= 1.02- 5.89, p=0.043). Conclusions: Cardiovascular involvement in BD is frequent in the Tunisian context with a broad spectrum of manifestations ranging from vascular involvement to cardiac one. Male gender, patients with erythema nodosum or neurologic involvement are prone to develop cardiovascular features of BD needing therefore close monitoring.