Granulomatosis with polyangiitis and cardio vascular co-morbidity in Denmark. A registry-based study of 21 years of follow-up

Objectives: To describe the epidemiology of granulomatosis with polyangiitis (GPA) in Denmark. To investigate if cardiovascular (CV) related comorbidity and death were increased among Danish AAV patients registered with a diagnosis of granulomatosis with polyangiitis (GPA) in Denmark. To investigate...

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Autores principales:	Helle Laustrup, Anne Voss, Peter Enemark Lund
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	ANCA associated Vasculitis Epidemiology Cardiovascular disease GPA Incidence Prevalence Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/389a12091fff47378220c94eee511d3d
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spelling	oai:doaj.org-article:389a12091fff47378220c94eee511d3d2021-11-26T04:38:42ZGranulomatosis with polyangiitis and cardio vascular co-morbidity in Denmark. A registry-based study of 21 years of follow-up2589-909010.1016/j.jtauto.2021.100136https://doaj.org/article/389a12091fff47378220c94eee511d3d2021-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2589909021000563https://doaj.org/toc/2589-9090Objectives: To describe the epidemiology of granulomatosis with polyangiitis (GPA) in Denmark. To investigate if cardiovascular (CV) related comorbidity and death were increased among Danish AAV patients registered with a diagnosis of granulomatosis with polyangiitis (GPA) in Denmark. To investigate if there was a temporal relation between diagnosis of GPA and CV disease and death. Methods: A population-based cohort study was performed using the Danish Civil Registration System, the Danish National Patient Registry and the Danish Cause of Death Register in the period January 1, 1995, to December 31, 2015. Patients registered twice or more with a diagnosis of GPA were included. Annual incidence rate (IR), point prevalence (PP) and standardized mortality rate (SMR) were calculated. The entire adult population in Denmark served as control population. CV morbidity and death caused by CV disease was registered. Results: We identified 1829 individuals with GPA. The median annual IR was 20.5/1,000,000 and PP increased from 64 to 277/1,000,000 in 2015. Overall SMR was 2.14. Among patients with GPA 171 had a hospital diagnosis of acute myocardial infarction (AMI). Compared to the control population, the hazard ratio (HR) of AMI was 2.47 (95% CI 1.24–4.94) during the first 3 months after the GPA diagnosis. From 3 months to one year declining to 1.41 (95%CI 0.80–2.49) and after 10 years the HR was still slightly increased to 1.64 (95%CI 1.20–2.23). The risk of a diagnosis of heart failure (HF) was markedly increased with a HR at 7.22 (95% CI 4.55–11.46) during the first 3 months after a GPA diagnosis, after three months up to one year 2.94 (95%CI 1.87–4.69), and 2.07 (95% CI 1.54–2.78) after 10 years. The total number of CV deaths in the GPA cohort was 307. During the first three months after a GPA diagnosis, the HR was increased to 9.51 (95%CI 7.12–12.70) declining to 2.51 (95% CI 1.77–3.58) after one year, but still increased to 1.56 (95% CI 1.23–1.98) after 10 years. Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation. Conclusion: In a population-based study on GPA, we found stable incidence, increasing prevalence and an overall increased SMR. The risk of CV comorbidity and of CV death among patients with a register diagnosis of GPA was increased.Helle LaustrupAnne VossPeter Enemark LundElsevierarticleANCA associated VasculitisEpidemiologyCardiovascular diseaseGPAIncidencePrevalenceImmunologic diseases. AllergyRC581-607ENJournal of Translational Autoimmunity, Vol 4, Iss , Pp 100136- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ANCA associated Vasculitis Epidemiology Cardiovascular disease GPA Incidence Prevalence Immunologic diseases. Allergy RC581-607
spellingShingle	ANCA associated Vasculitis Epidemiology Cardiovascular disease GPA Incidence Prevalence Immunologic diseases. Allergy RC581-607 Helle Laustrup Anne Voss Peter Enemark Lund Granulomatosis with polyangiitis and cardio vascular co-morbidity in Denmark. A registry-based study of 21 years of follow-up
description	Objectives: To describe the epidemiology of granulomatosis with polyangiitis (GPA) in Denmark. To investigate if cardiovascular (CV) related comorbidity and death were increased among Danish AAV patients registered with a diagnosis of granulomatosis with polyangiitis (GPA) in Denmark. To investigate if there was a temporal relation between diagnosis of GPA and CV disease and death. Methods: A population-based cohort study was performed using the Danish Civil Registration System, the Danish National Patient Registry and the Danish Cause of Death Register in the period January 1, 1995, to December 31, 2015. Patients registered twice or more with a diagnosis of GPA were included. Annual incidence rate (IR), point prevalence (PP) and standardized mortality rate (SMR) were calculated. The entire adult population in Denmark served as control population. CV morbidity and death caused by CV disease was registered. Results: We identified 1829 individuals with GPA. The median annual IR was 20.5/1,000,000 and PP increased from 64 to 277/1,000,000 in 2015. Overall SMR was 2.14. Among patients with GPA 171 had a hospital diagnosis of acute myocardial infarction (AMI). Compared to the control population, the hazard ratio (HR) of AMI was 2.47 (95% CI 1.24–4.94) during the first 3 months after the GPA diagnosis. From 3 months to one year declining to 1.41 (95%CI 0.80–2.49) and after 10 years the HR was still slightly increased to 1.64 (95%CI 1.20–2.23). The risk of a diagnosis of heart failure (HF) was markedly increased with a HR at 7.22 (95% CI 4.55–11.46) during the first 3 months after a GPA diagnosis, after three months up to one year 2.94 (95%CI 1.87–4.69), and 2.07 (95% CI 1.54–2.78) after 10 years. The total number of CV deaths in the GPA cohort was 307. During the first three months after a GPA diagnosis, the HR was increased to 9.51 (95%CI 7.12–12.70) declining to 2.51 (95% CI 1.77–3.58) after one year, but still increased to 1.56 (95% CI 1.23–1.98) after 10 years. Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation. Conclusion: In a population-based study on GPA, we found stable incidence, increasing prevalence and an overall increased SMR. The risk of CV comorbidity and of CV death among patients with a register diagnosis of GPA was increased.
format	article
author	Helle Laustrup Anne Voss Peter Enemark Lund
author_facet	Helle Laustrup Anne Voss Peter Enemark Lund
author_sort	Helle Laustrup
title	Granulomatosis with polyangiitis and cardio vascular co-morbidity in Denmark. A registry-based study of 21 years of follow-up
title_short	Granulomatosis with polyangiitis and cardio vascular co-morbidity in Denmark. A registry-based study of 21 years of follow-up
title_full	Granulomatosis with polyangiitis and cardio vascular co-morbidity in Denmark. A registry-based study of 21 years of follow-up
title_fullStr	Granulomatosis with polyangiitis and cardio vascular co-morbidity in Denmark. A registry-based study of 21 years of follow-up
title_full_unstemmed	Granulomatosis with polyangiitis and cardio vascular co-morbidity in Denmark. A registry-based study of 21 years of follow-up
title_sort	granulomatosis with polyangiitis and cardio vascular co-morbidity in denmark. a registry-based study of 21 years of follow-up
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/389a12091fff47378220c94eee511d3d
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Granulomatosis with polyangiitis and cardio vascular co-morbidity in Denmark. A registry-based study of 21 years of follow-up

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