Abstract：
OBJECTIVE: Giant cell arteritis (GCA) is one of the most common large vessel (LVV) vasculitis and is associated with a high risk of relapse and cardiovascular complications. Improving risk stratification remains a significant issue in this patient population. We aimed to perform a cluster analysis among GCA to identify clusters and evaluate their prognostic value.
METHODS: In a multicenter cohort study, we performed hierarchical cluster analysis on the factor analysis of mixed data coordinates results with 283 GCA patients\' characteristics to generate clusters and assess incidence of relapse, cardiovascular events and death.
RESULTS: Three clusters were identified: \"Vascular relapsing profile\" (23.0%), \"Typical GCA profile\" (47.7%), and \"Ophthalmologic elderly profile\" (29.3%). The \"Vascular relapsing profile\" cluster included younger patients with more frequent relapses and cardiovascular events, particularly thoracic aortic aneurysms. The \"Typical GCA profile\" was the largest, with classic cranial manifestations and frequently associated polymyalgia rheumatica. The \"Ophthalmologic elderly profile\" had the oldest patients with more visual loss and the highest mortality rate.
CONCLUSIONS: Our findings underline the varied prognostic landscape within GCA, emphasizing the poor cardiovascular prognosis of younger patients with LV involvement and the higher mortality among elderly patients. This reinforces the need for further research regarding the screening of aortic abnormalities and whether those patients might benefit from intensive treatment with biotherapy and cardiovascular risk factors management.
METHODS: In a multicenter cohort study, we performed hierarchical cluster analysis on the factor analysis of mixed data coordinates results with 283 GCA patients\' characteristics to generate clusters and assess incidence of relapse, cardiovascular events and death.
RESULTS: Three clusters were identified: \"Vascular relapsing profile\" (23.0%), \"Typical GCA profile\" (47.7%), and \"Ophthalmologic elderly profile\" (29.3%). The \"Vascular relapsing profile\" cluster included younger patients with more frequent relapses and cardiovascular events, particularly thoracic aortic aneurysms. The \"Typical GCA profile\" was the largest, with classic cranial manifestations and frequently associated polymyalgia rheumatica. The \"Ophthalmologic elderly profile\" had the oldest patients with more visual loss and the highest mortality rate.
CONCLUSIONS: Our findings underline the varied prognostic landscape within GCA, emphasizing the poor cardiovascular prognosis of younger patients with LV involvement and the higher mortality among elderly patients. This reinforces the need for further research regarding the screening of aortic abnormalities and whether those patients might benefit from intensive treatment with biotherapy and cardiovascular risk factors management.
摘要：
目的：巨细胞动脉炎（GCA）是最常见的大血管（LVV）血管炎之一，与复发和心血管并发症的高风险相关。改善风险分层仍然是该患者群体中的重要问题。我们的目的是在GCA中进行聚类分析，以识别聚类并评估其预后价值。
方法：在一项多中心队列研究中，我们对283名GCA患者的混合数据坐标结果进行了因子分析，以产生聚类并评估复发率，心血管事件和死亡。
结果：确定了三个簇：“血管复发特征”（23.0％），“典型GCA档案”（47.7%），和“眼科老年人概况”（29.3%）。“血管复发特征”群包括复发和心血管事件更频繁的年轻患者，特别是胸主动脉瘤。“典型的GCA简介”是最大的，有典型的颅骨表现和经常相关的风湿性多肌痛。“眼科老年人概况”是年龄最大的患者，视力丧失更多，死亡率最高。
结论：我们的发现强调了GCA中不同的预后景观，强调年轻左心室受累患者的心血管预后不良，老年患者的死亡率较高。这加强了对主动脉异常筛查以及这些患者是否可能从生物治疗和心血管危险因素管理的强化治疗中受益的进一步研究的需要。
方法：在一项多中心队列研究中，我们对283名GCA患者的混合数据坐标结果进行了因子分析，以产生聚类并评估复发率，心血管事件和死亡。
结果：确定了三个簇：“血管复发特征”（23.0％），“典型GCA档案”（47.7%），和“眼科老年人概况”（29.3%）。“血管复发特征”群包括复发和心血管事件更频繁的年轻患者，特别是胸主动脉瘤。“典型的GCA简介”是最大的，有典型的颅骨表现和经常相关的风湿性多肌痛。“眼科老年人概况”是年龄最大的患者，视力丧失更多，死亡率最高。
结论：我们的发现强调了GCA中不同的预后景观，强调年轻左心室受累患者的心血管预后不良，老年患者的死亡率较高。这加强了对主动脉异常筛查以及这些患者是否可能从生物治疗和心血管危险因素管理的强化治疗中受益的进一步研究的需要。
