Arq Bras Cardiol. 2025 Dec;122(12):e20250534. doi: 10.36660/abc.20250534.
ABSTRACT
BACKGROUND: Initial clinical and imaging associations in Takayasu's arteritis (TAK) are poorly defined.
OBJECTIVES: To characterize initial manifestations, their associations, and long-term outcomes in a TAK cohort.
METHODS: A single-center retrospective cohort study (2000 to 2024) included patients diagnosed with TAK. The significance level was set at p<0.05.
RESULTS: Among 203 patients identified, 54 were excluded due to incomplete data. The final cohort comprised 149 patients (89.9% female), with a median age at diagnosis of 31 years. At diagnosis, 92.6% were symptomatic. Claudication of upper (36.2%) and lower (30.9%) limbs was frequent, alongside advanced vascular damage like stenosis (85.9%) and occlusions (52.3%). Upper limb claudication was independently predicted by reduced upper limb pulses (OR=4.83; 95%CI=2.08-11.24; p=0.001) and right subclavian artery occlusion (OR=8.06; 95%CI=1.94-33.44; p=0.004). Lower limb claudication was predicted by right subclavian artery occlusion (OR=6.65; 95%CI=2.05-21.61; p=0.002), right subclavian artery thickening (OR=5.12; 95%CI=1.18-22.71; p=0.029), and left subclavian artery stenosis (OR=2.71; 95%CI=1.21-60.56; p=0.016). Over a median 10-year follow-up, despite 91.3% remission, cardiovascular comorbidities increased, and 26.8% required surgery.
CONCLUSIONS: Limb claudication is a key prognostic indicator of advanced radiological damage and diagnostic delay. This is reinforced by a long-term dissociation between high clinical remission and progressive vascular disease, demanding vigilant monitoring.
PMID:41637325 | DOI:10.36660/abc.20250534