To describe, in a real-life setting, the direct causes of death in a cohort of consecutive patients with giant cell arteritis (GCA).We retrospectively analyzed the deaths that occurred in a cohort of 470 consecutive GCA patients from a center of expertise between January 2000 and December 2019. Among the 120 patients who died, we retrieved data from the medical files of 101 patients.Cardiovascular events were the dominant cause of death (n = 41; 41%) followed by infections (n = 22, 22%), geriatric situations (i.e. falls or senile deterioration; n = 17, 17%) and cancers (n = 15, 15%). Patients in each of these four groups were compared with the other deceased patients pooled together. Patients who died from cardiovascular events were more frequently male (46% vs 27%, p= 0.04) with a past history of coronary artery disease (29% vs 8%, p= 0.006). Patients who died from infections mostly had ongoing glucocorticoid treatment (82% vs 53%, p= 0.02) with higher cumulative doses (13994 mg vs 9150 mg, p= 0.03). Patients who died from geriatric causes more frequently had osteoporosis (56% vs 17%, p= 0.0009) and had mostly discontinued glucocorticoid treatment (76% vs 33%, p= 0.001). The predictive factors of death in multivariate analysis were a history of coronary disease (HR: 2.39; 95% CI: 1.27-4.21; p= 0.008), strokes at GCA diagnosis (HR: 2.54; 95% CI: 1.05-5.24; p= 0.04), any infection during follow-up (HR: 1.93; 95% CI: 1.24-2.98; p= 0.004) and fever at GCA diagnosis (HR: 1.99; 95% CI: 1.16-3.28; p= 0.01).Our study provides real-life insight on the cause-specific mortality in GCA patients.
Authors: Luca Antonini, Anael Dumont, Amandine Lavergne, Paul Castan, Clivia Barakat, Sophie Gallou, Audrey Sultan, Samuel Deshayes, Achille Aouba, Hubert de Boysson