Low-dose aspirin and
prevention of cranial ischemic complications in giant cell
arteritis.
Arthritis
Rheum. 2004; 50(4):1332-7 (ISSN: 0004-3591)
Nesher G;
Berkun Y; Mates M; Baras M; Rubinow A;
Sonnenblick M
Department of Internal Medicine, Shaare Zedek Medical
Center, Jerusalem, Israel. [EMAIL PROTECTED]
OBJECTIVE: Cranial ischemic complications
such as cerebrovascular accidents (CVAs) and acute visual loss are among the
leading causes of giant cell arteritis (GCA)-related morbidity. In this
retrospective study, we evaluated the effect of treatment with low-dose aspirin
on the incidence of cranial ischemic complications in GCA. METHODS: Charts of
175 consecutive patients in whom GCA was diagnosed between 1980 and 2000 were
reviewed for medical data. Data for 166 patients who were followed up for at
least 3 months were also available. RESULTS: At the time of the diagnosis of
GCA, 36 patients (21%) had already been receiving low-dose aspirin (100 mg/day).
In all cases, the indication for this treatment was ischemic heart disease.
There were no significant differences between the aspirin-treated and
non-aspirin-treated groups regarding the mean age of patients, the
male-to-female ratio, duration of GCA-related symptoms, rates of headaches,
systemic symptoms, and jaw claudication, and the mean erythrocyte sedimentation
rate, hemoglobin count, and platelet count. Cerebrovascular risk factors
(hypertension, hyperlipidemia, or diabetes mellitus) were more common in the
aspirin-treated group (38.9% versus 20%; P= 0.03). Cranial ischemic
complications were diagnosed in 43 patients at presentation: 30 patients had
acute visual loss, 11 had CVAs, and 2 had both conditions simultaneously. Only 3 of the aspirin-treated
patients (8%) presented with cranial ischemic complications, compared with 40
(29%) of the non-aspirin-treated patients (P = 0.01). Despite the use of
steroid therapy, cranial ischemic complications developed in 14 of the 166
patients followed up for 3 months or longer. However, cranial ischemic
complications developed in only 3% of the aspirin-treated patients, compared
with 13% of the patients treated with prednisone only (P = 0.02). CONCLUSION: These data suggest
that low-dose aspirin decreases the rate of visual loss and CVAs in patients
with GCA.
