342. Is Plasma Viscosity an Acceptable Substitute for Erythrocyte Sedimentation Rate for the Diagnosis of Giant Cell Arteritis? (original) (raw)

to the ACR 1990 criteria or the CHCC diagnostic criteria in the three rheumatology departments of the two city hospitals in Kyiv between 1972 and 2010. Survival was calculated using the Kaplan-Meier method. Demographics (age at diagnosis, sex), clinical and laboratory parameters (including ESR, the presence of hepatitis B virus (HBV) and creatinine level), were tested as potential prognostic factors in multivariate Cox models. Clinical activities of patients were calculated according to the Birmingham Vasculitis Activity Score (BVAS). Results: The median duration of follow-ups was 92 months and 15 (28.3%) deaths were recorded. According to the analysis 25% of patients with PAN die within the first 7 years, and 50% don't live more than 17 years. Cumulative survival rates at 1, 3, 5 and 10 years was 88.6; 84.2; 81.8 and 68.2%, respectively. Comparison survival of patients with PAN according to age and sex revealed that gender cumulative survival function didn't differ significantly (P ¼ 0.58), but age at onset of the disease of more than 60 years significantly reduces the survival of patients with PAN. Survival curves of groups of patients with different disease activity determined by BVAS were not significantly different (P ¼ 0.59). HBV infection in patients with PAN and ESR level at the onset of the disease didn't affect the survival of patients. Multivariate analysis showed that presence of increased creatinine levels more than 140 mg/ dl, cardiac involvement and patient age over 60 years were significant negative prognostic factors for patient survival. Other factors (including weight loss, gastrointestinal and CNS involvement, diastolic hypertension, etc.) didn't have influence on the survival curves. Comparison groups of patients with PAN distributed by the 5-factor score revealed the presence of two or more adverse prognostic factors significantly reduce survival (p < 0.05), and the presence of only one factor has no effect on mortality. Conclusion: Despite current treatment the prognosis of patients with PAN remains unfavourable. Cumulative survival of patients with PAN at 1, 3, 5 and 10 years of observation is 89, 84, 82 and 68%, respectively. Vasculitis activity detected by BVAS and the level of ESR no effect on mortality. The increased creatinine levels more than 140 mg/dl, presence of cardiac involvement and patient age over 60 years are predictors of poor survival of patients with PAN.