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Coronary involvement in patients with Behçet’s disease

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Abstract

Objectives

To investigate the clinical features and potential risk factors of coronary involvement in Behçet’s disease (BD).

Method

In this case-control study, we retrospectively reviewed medical records of BD patients admitted to our institute from 2000 to 2016. Coronary involvement was documented by coronary angiography and (or) computed tomography angiography. We analyzed the demographic, clinical, and laboratory data and compared with age- and gender-matched BD patients without coronary involvement.

Results

Among 476 BD patients (296 males) enrolled, 19 (4.0%) patients (17 males) were diagnosed with coronary involvement. The median duration from onset of BD to coronary involvement was 2.8 years. Coronary stenosis, aneurysm, and occlusion were presented in 13, 9, and 3 patients, respectively. Multiple coronary artery stenoses and aneurysms were observed in 9 and 3 patients, respectively. Smoking (36.8%) was the major traditional risk factors. Male gender (89.5% vs 61.1%, p = 0.01), skin lesions (78.9% vs 55.3%, p = 0.08), pathergy reactions (36.8% vs 10.5%, p = 0.01), extra-cardiac vasculitis (36.8% vs 6.6% p < 0.01), elevated ESR (57.9% vs 34.2%, p = 0.01), and elevated CRP (63.2% vs 42.1%, p < 0.01) were more common in BD patients with coronary involvement comparing with those without coronary involvement. Multivariate analysis confirmed pathergy reaction (OR = 3.81, 95% CI 1.08–13.47) was the independent risk factor.

Conclusions

Coronary involvement in BD patients is rare and male-predominant and is characterized by the aneurysm and multivessel involvement. Elevated ESR and CRP are frequent, and the pathergy reaction is the independent risk factor.

Key Points

• Coronary involvement in BD patients is rare and male-predominant.

• Pathergy reaction is the risk factor for coronary involvement in BD patients.

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Acknowledgments

We gratefully acknowledge all patients who participated in our study.

Funding

This study was supported by grants from the National Key Research and Development Program: “Precise Medical Research” (2016YFC0906201), National Natural Science Foundation of China (81571598, 81871299), CAMS Initiative for Innovative Medicine (2016-I2M-1-013, 2017-I2M-1-008), PUMC Youth Fund (3332016005), the Fundamental Research Funds for the Central Universities (3332016005), and 2016 PUMCH Science Fund for Junior Faculty (PUMCH-2016-1.7).

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Author notes

  1. Hua Chen and Yuehua Zhang contributed equally to this work.

Authors and Affiliations

  1. Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China

    Hua Chen, Yuehua Zhang, Chaoran Li, Jinjing Liu, Fengchun Zhang & Wenjie Zheng

  2. Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China

    Hua Chen, Yuehua Zhang, Chaoran Li, Jinjing Liu, Fengchun Zhang & Wenjie Zheng

  3. Department of Oncology and Immunology, The fourth hospital of Hebei Medical University, Hebei, 050000, China

    Yuehua Zhang

  4. Department of Cardiology, Peking Union Medical College Hospital, Beijing, China

    Wei Wu

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  1. Hua Chen
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Corresponding author

Correspondence to Wenjie Zheng.

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The study was reviewed and approved by the institutional ethics review board of Peking Union Medical College Hospital per the Declaration of Helsinki. Given that the study was based on the review of medical records, written informed consent was waived.

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Chen, H., Zhang, Y., Li, C. et al. Coronary involvement in patients with Behçet’s disease. Clin Rheumatol 38, 2835–2841 (2019). https://doi.org/10.1007/s10067-019-04640-z

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  • DOI: https://doi.org/10.1007/s10067-019-04640-z

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