LONDON – Among patients with giant cell arteritis, those in the lowest socioeconomic quarter of the population were more than three times as likely to have ischemic complications, based on data from 271 patients in England. The results were presented today.
Previous studies have shown a link between low socioeconomic status and carotid atherosclerosis. Studies of giant cell arteritis (GCA) have not controlled for socioeconomic status as a possible confounder, said Dr. Sarah Louise Mackie of the University of Leeds (England).
In an observational study of patients from eight recruitment centers in England, Dr. Mackie and her colleagues identified 271 confirmed cases of GCA.
Overall, 222 of 271 patients had ischemic complications. "The most striking finding was an association of ischemic complications with increasing Index of Deprivation 2007 (IMD2007) scores," with an odds ratio of 4.2 for the most-deprived quartile compared with the least-deprived quartile, Dr. Mackie noted. After controlling for a 30-day median duration of symptoms, the odds ratio for ischemic complications was 3.2 for the most-deprived quartile compared with the least-deprived quartile.
Ischemic complications were defined as lost or blurred vision; visual aura; diplopia; claudication of the jaw, tongue, or limb; scalp necrosis; or cerebral or myocardial ischemia.
Smoking was not associated with an increased risk of ischemic complications. Falling into the most socioeconomically deprived quartile was associated with a higher lifetime tobacco exposure and a lower prevalence of previously diagnosed polymyalgia rheumatica. However, neither of these factors appeared to affect the impact of socioeconomic deprivation on complications.
The adjusted odds ratio for the influence of hypertension was 1.6, and the adjusted odds ratio for the influence of atherosclerosis was 1.5. Neither of these conditions appeared to mediate the effect of socioeconomic deprivation on ischemic complications.
"This is a novel finding that requires replication," Dr. Mackie noted. Meanwhile, any public awareness campaign for GCA "should attempt to engage individuals in more deprived areas to encourage early presentation and prompt treatment," she said.
Dr. Mackie said she had no financial conflicts to disclose.