AB1286 CT-FFR COMBINED WITH IL-6 CAN PREDICT MAJOR ADVERSE CARDIOVASCULAR EVENTS IN TA PATIENTS
Authors: L. Pan, S. Yang
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Takayasu arteritis (TA) often occurs in young women and mainly affects aorta and its primary branches[1]. Coronary artery originates from the aortic root and coronary involvement is not rare in TA. Baseline active disease and coronary involvement are independently associated with major adverse cardiovascular events (MACEs)[2]. TA patients with active disease have higher IL-6 levels than in patients with stable disease[3]. Fractional Flow Reserve (FFR) is deemed to the gold standard for the estimate of ischemic potential of coronary lesions[4]. FFR and CT-FFR have a strong positive correlation[5]. Several clinical and registry studies have confirmed that CT-FFR has a good prognostic value [6]. Whether the combination of CT-FFR and IL-6 can predict MACEs for TA is worth studying. <h3>Objectives:</h3> The aim of our study is to estimate the value of CT-FFR and IL-6 to predict MACEs in TA patients. <h3>Methods:</h3> The study enrolled a total of 78 TA patients who had coronary involvement. All patients were divided into two groups according to the absence or presence of MACEs (57 vs 21). We measured the CT-FFR of 3 arteries (including left anterior descending artery, left circumflex artery and right coronary artery) and compared clinical characteristics and ancillary findings between the two groups. Cox regression model was established to find risk factors and NRI, IDI were adopted to compare model differences. <h3>Results:</h3> Elevated IL-6 and the CT-FFR LAD positive were risk factors for patients with MACEs. (HR[95%CI] 11.293 [2.314-55.107], p=0.003;16.007 [1.721-148.849], P=0.015) (Table 1). Baseline model 1 included age, sex, BMI, hypertension, diabetes mellitus, dyslipidemia, myocardial infarction and smoking. Baseline model 2 included ESR and hs-CRP.Adding elevated IL-6 and CT-FFR LAD positive to the baseline model 1 had a significant incremental effect on prognostic prediction with NRI of 0.280 (p<0.001) and IDI of 0.375 (p=0.039). Adding both of them to the baseline model 2 also had a significant incremental effect on prognostic prediction with NRI of 0.174 and IDI of 0.238 (both p=0.020) (Table 2). <h3>Conclusion:</h3> Elevated IL-6 and CT-FFR LAD positive are predictive factors for the development of MACEs in TA with coronary involvement. Adding them to the baseline models can optimize the predictive power of the model. For patients with elevated IL-6 levels or CT-FFR LAD positive, more attention should be paid to the follow-up of the coronary arteries and the occurrence of MACEs. <h3>REFERENCES:</h3> [1] Kerr GS, Hallahan CW, Giordano J, Leavitt RY, Fauci AS, Rottem M, Hoffman GS: Takayasu arteritis. <i>Ann Intern Med</i> 1994, 120(11):919-929. [2] Wang H, Liu Z, Shen Z, Fang L, Zhang S: Impact of coronary involvement on long-term outcomes in patients with Takayasu's arteritis. <i>Clin Exp Rheumatol</i> 2020, 38(6):1118-1126. [3] Park MC, Lee SW, Park YB, Lee SK: Serum cytokine profiles and their correlations with disease activity in Takayasu's arteritis. <i>Rheumatology (Oxford</i>) 2006, 45(5):545-548. [4] Tonino PA, De Bruyne B, Pijls NH, Siebert U, Ikeno F, van' t Veer M, Klauss V, Manoharan G, Engstrom T, Oldroyd KG <i>et al</i>: Fractional flow reserve versus angiography for guiding percutaneous coronary intervention. <i>N Engl J Med</i> 2009, 360(3):213-224. [5] Michail M, Ihdayhid AR, Comella A, Thakur U, Cameron JD, McCormick LM, Gooley RP, Nicholls SJ, Mathur A, Hughes AD <i>et al</i>: Feasibility and Validity of Computed Tomography-Derived Fractional Flow Reserve in Patients With Severe Aortic Stenosis: The CAST-FFR Study. <i>Circ Cardiovasc Interv</i> 2021, 14(1):e009586. [6] Ci W, Zhao Y, Bi T: Male Patients with Takayasu Arteritis and Coronary Artery Involvement are Prone to Have Serious Coronary Stenosis and High Mortality. <i>Curr Vasc Pharmacol</i> 2022, 20(1):62-68. <b>Table 1.</b> Cox proportional hazards model of TA patients with MACEs. <b>Table 2.</b> NRI and IDI for the incremental predictive values of various models. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>