Effect of positive serum anti-nuclear antibody on the risk of coronary artery disease in patients with Takayasu arteritis

Liao Hua; Du Juan; Pan Lili

doi:10.3760/j.issn.1673-4777.2024.06.014

Abstract：Objective To investigate the clinical significance of positive anti-nuclear antibody(ANA)in patients with Takayasu arteritis(TA)and its impact on the risk of coronary artery disease.Methods A total of 158 patients with TA and without other immune diseases who were hospitalized in Beijing Anzhen Hospital,Capital Medical University from January 2014 to February 2022 were enrolled.According to the results of ANA,the patients were divided into ANA positive group(46 cases)and ANA negative group(112 cases).The general data,laboratory examination and imaging data of the subjects were collected,and the correlation analysis between the groups was performed.Logistic regression method was used to analyze the related risk factors,and the prediction model was established.Receiver operating characteristic(ROC)curve was used to compare the area under the curve(AUC)of different prediction models,and the clinical significance of positive ANA in patients with TA was analyzed.Results The incidence of hyperlipidemia was higher in ANA positive group than in ANA negative group[23.9％(11/46)vs 7.1％(8/112)](P=0.003).The incidence of coronary artery lesions in ANA positive group was significantly higher than that in ANA negative group[50.0％(23/46)vs 22.3％(25/112)](P=0.001).Multivariate Logistic regression analysis showed that positive ANA and hyperlipidemia were independent risk factors for coronary artery lesions in patients with TA(both P＜0.05).The ROC curve analysis showed that the AUC of the model based on age of onset,gender,course of disease,body mass index,National Institutes of Health(NIH)score and hyperlipidemia history was 0.713(P=0.001),and the AUC of the prediction model increased to 0.761 when ANA was added as a risk factor(P＜0.001).For patients without a history of hyperlipidemia(139 cases),the prediction model was constructed based on multivariate Logistic regression analysis,including age,gender,course of disease,body mass index and NIH score,and the AUC of the baseline model was 0.645(P=0.046),and the AUC increased to 0.709 when positive ANA was added as a risk factor(P=0.004).Conclusion Coronary artery disease should be alert to patients with TA combined with positive ANA,especially in patients without hyperlipidemia.