• Vascular Annual Meeting
• General Information
• Call for Abstracts
• Exhibitor Information
• Future Meeting Dates
• Past Meeting Information
• Contact Us

Quality Of Life Of Patients With Takayasu's Arteritis

Christopher J. Abularrage, MD,^1,2 Mark B. Slidell, MD, MPH,^1,2 Anton N. Sidawy, MD, MPH,^1,2,3 Peter Kreishman, MD,¹ Richard Amdur, Ph.D,¹ Subodh Arora, MD,^1,3
1Surgical Service, Veterans Affairs Medical Center, Washington, DC; ²Department of Surgery, Georgetown University Hospital, Washington, DC; ³Department of Surgery, George Washington University Medical Center

OBJECTIVE:  Takayasu's Arteritis (TA) is a chronic, immune vasculitis causing inflammation of the aorta and its branches, and clinically characterized by exacerbations and remissions.  This study examined the quality of life (QoL) of patients with TA using the Short Form-36 (SF-36), a validated health related QoL questionnaire.

METHODS:  392 patients enrolled in the Takayasu’s Arteritis Research Association were mailed a questionnaire that included the SF-36 and demographic variables.  Raw SF-36 scores, and Physical Health Summary (PHS) and Mental Health Summary (MHS) scores, were calculated according to standard protocols.  Data were analyzed for predictors of superior QoL using univariate and stepwise logistic regression analysis. SF-36 scores were also compared to those of other chronic diseases associated with peripheral vascular disease (PVD) published in the literature. 

RESULTS: 158 patients (144 female, 14 male) with average age 42.2 years (SEM=1.1) responded to the questionnaire.  Mean onset of symptoms occurred at 30.5 ± 1.2 years. The mean age at diagnosis was 34.7 ± 1.2 years, with a median of 4 doctors seen before diagnosis.  Mean delay in diagnosis was 3.9 ± 0.5 years.  The group underwent a total of 299 TA related surgical procedures (1.9 ± 0.3 per patient), including coronary (38.0%), carotid (34.8%), upper extremity (30.4%), and lower extremity (26.0%) revascularization.  PHS and MHS summary scores (39.2 ± 1.0 and 44.5 ± 1.0, respectively) were worse than age-matched healthy population means, as well as nationally reported scores for diabetes mellitus, hypertension, and coronary artery disease (all P<.0001).  Multivariate predictors of better physical QoL were younger age (P=.003) and remission of disease (P=.0002).  The use of immunomodulating medications was associated with inferior physical QoL (P=.02).  The sole predictor of better mental QoL was remission of disease (P=.002).

CONCLUSION:  TA is a rare disease with profound consequences on QoL.  Delay in diagnosis is common and most patients will undergo peripheral vascular surgery during their lifetime.  Physical and mental health are worse compared to many other chronic diseases associated with PVD.  Superior physical QoL is seen in younger patients, whereas inferior physical QoL is encountered in those on immunomodulating medications.  Since disease remission is the only factor to influence positively both physical and mental QoL, every effort should be directed to attenuate disease activity in this patient population.