High incidence of severe ischaemic complications in patients with giant cell arteritis irrespective of platelet count and size, and platelet inhibition

• Published in: Rheumatology (Oxford, England) England), 2009-03, Vol.48 (3), p.258-261
• Main Authors: Berger, C. T., Wolbers, M., Meyer, P., Daikeler, T., Hess, C.
• Format: Article
• Language: English
• Subjects: Acetylsalicylic acid; Aged; Aged, 80 and over; Aspirin - therapeutic use; Biological and medical sciences; Blood Platelets - pathology; Bones, joints and connective tissue. Antiinflammatory agents; Brain Ischemia - blood; Brain Ischemia - etiology; Cell Size; Diseases of the osteoarticular system; Female; Giant cell arteritis; Giant Cell Arteritis - blood; Giant Cell Arteritis - complications; Giant Cell Arteritis - drug therapy; Humans; Ischaemia; Ischemia - blood; Ischemia - etiology; Male; Medical sciences; Middle Aged; Optic Neuropathy, Ischemic - blood; Optic Neuropathy, Ischemic - etiology; Pharmacology. Drug treatments; Platelet Aggregation Inhibitors - therapeutic use; Platelet Count; Platelets; Retrospective Studies; Risk factors; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Stroke - blood; Stroke - etiology; Vision Disorders - blood; Vision Disorders - etiology
• ISSN: 1462-0324; 1462-0332
• DOI: 10.1093/rheumatology/ken480

Objective. Vision loss and ischaemic stroke are feared complications in GCA. We investigated how platelet count and size and platelet inhibition with ASA relate to ischaemic complications in patients with GCA. Methods. Charts of patients with GCA were retrospectively analysed. Jaw claudication, amaurosis fugax, blurred vision, ischaemic stroke and permanent visual loss were classified as ‘ischaemic events’; ischaemic stroke and permanent visual loss were sub-grouped as ‘severe ischaemic events’. The incidence of ischaemia and the association to the pre-defined covariates age, fever, ESR, platelet count and size and ASA treatment were assessed. Results. Eighty-five patients (mean age 73 yrs, 60% women, 78% biopsy-proven) were included in the analysis. Of the 85 patients, 62 (73%) presented with ischaemic events, 29/85 patients (34%) with severe ischaemic events. At the time of diagnosis 22/85 patients (26%) were treated with ASA. Of these 22 patients, 15 (68%) presented with ischaemic events, 7/22 patients (32%) with severe ischaemic events. In multivariate analysis, neither platelet count nor size or ASA treatment were significantly associated with ischaemic or severe ischaemic events. Conclusions. The incidence of severe ischaemic events in patients with GCA was high, irrespective of platelet count and size and established ASA treatment.