Mortality of large-artery complication (Aortic aneurysm, aortic dissection, and/or large-artery stenosis) in patients with giant cell arteritis - A population-based study over 50 years

Objective. To determine the mortality of giant cell arteritis (GCA) with large-artery complication compared with that of GCA without large-artery complication. Methods. An inception cohort of 168 residents of Olmsted County, Minnesota, in whom GCA was diagnosed, between January 1, 1950, and December 31, 1999, was followed up. Mortality in patients with incident large-artery complication (aortic aneurysm, aortic dissection, and large-artery stenosis) was determined and compared with that in patients in whom large-artery complication did not develop. Results. No difference in survival was observed between the total group of patients with any type of large-artery complication and patients without large-artery complication or the general population. However, mortality was markedly increased in the 9 patients in whom thoracic aortic dissection developed (median survival 1.1 years [interquartile range 0.27-7.8 years]) compared with that in all other patients with GCA (P < 0.001). No difference in survival was observed between the group of patients with either aortic aneurysm and/or dissection (thoracic and/or abdominal aorta) and the group with GCA without large-artery complication. Survival of patients with GCA and large-artery stenosis was not different from that of patients with GCA without large-artery complication. Conclusion. Thoracic aortic dissection in GCA is associated with markedly increased mortality. Overall, mortality in the whole group of patients with GCA with large-artery complication was similar to that in patients with GCA without large-artery complication.