Comparison of idiopathic (isolated) aortitis and giant cell arteritis-related aortitis. A French retrospective multicenter study of 117 patients

Olivier Espitia, Maxime Samson, Thomas Le Gallou, Jérôme Connault, Cedric Landron, Christian Lavigne, Cristina Belizna, Julie Magnant, Claire de Moreuil, Pascal Roblot, François Maillot, Elisabeth Diot, Patrick Jégo, Cécile Durant, A Masseau, Jean-Marie Brisseau, Pierre Pottier, Alexandra Espitia-Thibault, Anabele Dos Santos, François Perrin, Mathieu Artifoni, Antoine Néel, Julie Graveleau, Philippe Moreau, Hervé Maisonneuve, Georges Fau, Jean-Michel Serfaty, Mohamed Hamidou, Christian Agard
Autoimmunity Reviews 2016, 15 (6): 571-6

OBJECTIVES: The aim of the study was to compare clinical/imaging findings and outcome in patients with idiopathic (isolated aortitis, IA) and with giant cell arteritis (GCA)-related aortitis.

METHODS: Patients from 11 French internal medicine departments were retrospectively included. Aortitis was defined by aortic wall thickening >2mm and/or an aortic aneurysm on CT-scan, associated to inflammatory syndrome. Patients with GCA had at least 3 ACR criteria. Aortic events (aneurysm, dissection, aortic surgeries) were reported, and free of aortic events-survival were compared.

RESULTS: Among 191 patients with non-infectious aortitis, 73 with GCA and 44 with IA were included. Patients with IA were younger (65 vs 70 years, p=0.003) and comprised more past/current smokers (43 vs 15%, p=0.0007). Aortic aneurisms were more frequent (38% vs 20%, p=0.03), and aortic wall thickening was more pronounced in IA. During follow-up (median=34 months), subsequent development of aortic aneurysm was significantly lower in GCA when compared to IA (p=0.009). GCA patients required significantly less aortic surgery during follow-up than IA patients (p=0.02). Mean age, sex ratio, inflammatory parameters, and free of aortic aneurism survival were equivalent in patients with IA ≥ 60 years when compared to patients with GCA-related aortitis.

CONCLUSIONS: IA is more severe than aortitis related to GCA, with higher proportions of aortic aneurism at diagnosis and during follow-up. IA is a heterogeneous disease and its prognosis is worse in younger patients <60 years. Most patients with IA ≥ 60 years share many features with GCA-related aortitis.

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