43. Vasculitis Patients Suffering Stroke Have Comparable Clinical Presentation and Outcome to Non-Vasculitis Patients
Creators: name: Sode1, Jacob
name: Jens Rathmann1, 2
name: Stamatis1, Pavlos
name: Turesson3, Carl
name: Jayne4, David
name: Aladdin J. Mohammad1,2,4
Publisher: name: Zenodo
Year: 2022
Subjects: Vasculitis
ANCA
Abstracts
Giant Cell Arthritis
MPA
GPA
EGPA
Takayasu
IgA vasculitis

description: <strong>Background:</strong> An increased incidence of stroke has been shown among patients with giant-cell arteritis (GCA) and Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). With this study we aimed to identify differences in clinical presentation and outcomes from stroke, between systemic vasculitis- and non-vasculitis patients. <strong>Methods</strong>: The study cohort consist of 1527 patients with systemic vasculitis [SV: 1202 giant cell arteritis (GCA) and 325 ANCA associated vasculitis (AAV)] diagnosed in a defined geographic area in southern Sweden between January 1<sup>st</sup> 1997 – December 31<sup>st</sup> 2016. All SV patients diagnosed with stroke after the onset of their SV until December 31<sup>st</sup>, 2018, were identified by linking the SV cohort to the RIKSSTROKE, a Swedish national registry covering all stroke cases treated at a specialized stroke unit in Sweden (ICD-10 diagnoses; cerebral infarction (I63), - haemorrhage (I61), or unspecified haemorrhage or infarction (I64)). For each case with SV and stroke, 10 controls matched by sex, age, county of admission, and year of admission +/- 2 years, were identified from the RIKSSTROKE registry. Clinical data from time of admission to the stroke unit and data from 3-month follow-up were retrieved from Riksstroke and compared between SV and controls. <strong>Results: </strong>143 (9.4%) cases with SV, 127 with GCA (10.6%) and 16 with AAV (4.9%), were diagnosed with stroke after the onset of SV during the study period. Table 1 summarizes the clinical and demographic characteristics of patients and controls. A history of previous stroke was less common among patients with SV than their controls (14.2% vs. 27.4%, p=0.001), as was use of statins at admission (16.1% vs. 28.1, p=0.005). Prevalence of smoking and atrial fibrillation did not differ between patients with SV and controls, but there was a trend to a lower prevalence of antihypertensive therapy, and diabetes mellitus, among patients with SV (Table 1). Neither radiographic diagnosis (haemorrhage or ischemic infarction), nor level of consciousness at admission differed between cases with SV and controls. Frequency of thrombolysis treatment did not differ between cases and controls. Duration of hospital admission (9.1 vs. 10.3 days) and the occurrence of stroke related complications (deep vein thrombosis, pneumonia, or fracture) during admission were similar between cases and controls. Mortality rates at 3-month follow-up were identical in cases and controls (21.7%). <strong>Conclusions:</strong> In this population-based cohort study, we found that patients with SV who were admitted with stroke were less likely to have a previous history of stroke than non-vasculitis patients matched by sex, age, county-, and year of admission. On the other hand, we found no major differences in baseline clinical characteristics, admission related complications, nor mortality at 3-month follow-up. The impact of vasculitis features, as well as glucocorticoids and other anti-inflammatory therapies, on the risk and outcome of stroke needs further studies. <strong>Disclosures:</strong> None