Risk Factors and Pharmacological Interventions Impacting Cerebrovascular
Ischemic Events in Giant Cell Arteritis: A Narrative Review
Abstract
Abstract Giant cell arteritis (GCA) is a prevalent vasculitis primarily
affecting larger vessels, notably in individuals aged 70–79.
Cerebrovascular ischemic events (CIE), such as stroke and transient
ischemic attacks, are significant GCA complications, with a pooled
prevalence of 4%. CIEs are rare but debilitating complications of GCA.
This research article is a narrative review that aims to highlight the
risk factors and pharmacological interventions that impact GCA-related
CIE. This narrative review suggests that age, male gender, hypertension,
and smoking were significantly associated with GCA-related CIE, while
risk factors such as having anemia, a higher body mass index (BMI),
relatively higher inflammatory markers such as C-reactive protein (CRP),
and erythrocyte sedimentation rate (ESR) had protective effects against
GCA-related CIE. Symptoms of ischemia of the ophthalmic artery were also
found to be the strongest predictors of CIE. Pharmacological
interventions such as glucocorticoids and tocilizumab can help manage
and prevent CIE in GCA patients. Aspirin and antiplatelet therapy may
also be useful as adjunctive therapies. A detailed and appropriate study
design for various risk factors is required to establish the
association. Identifying risk factors is imperative for managing
morbidity and mortality. This can help physicians assess the risk and
prevent CIE in GCA patients.