Cardiovascular Burden in Behcet’s Disease
Presenter
Amanda Meredith, MD, Rutgers New Jersey Medical School, Newark, NJ
Amanda Meredith, MD1, Nebojsa Marcovic, MD1, Abhishek Nimkar, MD2, Geetika Arora, MD3 and Ashutossh Naaraayan, MD2, (1)Rutgers New Jersey Medical School, Newark, NJ, (2)Montefiore New Rochelle Hospital, New Rochelle, NY, (3)Mount Sinai Beth Israel, New York City, NY
Keywords: Coronary, Venous Disease and Women's Health
Background
Behcet’s Disease (BD) is a multisystem vasculitic disorder characterized mainly by systemic ulcerations. The etiology of BD is not well understood although an association to the gene HLA-B51 has been described. BD is unique among the vasculitides in that it has the ability to involve vessels of all types and sizes leading to its multiorgan manifestation. Cardiovascular (CV) burden in BD has not yet been described in the United States and we aim to analyze inpatient data to describe the incidence, CV burden and outcomes of those with BD.
Methods
A descriptive, retrospective study was conducted on the National Inpatient Sample (NIS) database for the year 2016. Adult (>18 years) inpatient admissions with diagnosis of BD were selected based on ICD-10, Clinical Modification diagnoses codes (M352).
Results
In 2016, of the 30,195,722 hospitalizations 2,975 had a diagnosis of BD. The mean age of patients with BD was 48.3 +/- 15.9 years, 70.2% were female and 71.9% were white. Patients admitted with BD were more likely to be younger (48.3 +/- 15.9 vs 57.5 +/- 20.3, p<0.001), women (70.2% vs 58.2%, <0.001), white (71.9% vs 67.8%, 0.04) and to have a higher Elixhauser comorbidity score (3.7 +/-1.9 vs 3.03 +/- 2.4, <0.001) than patients without BD. The most common CV manifestations in patients with BD were: arrhythmia (7.4%), congestive heart failure (7.2%), dilated cardiomyopathy (1.9%), arterial aneurysm (1.7%), myocardial infarction (1%), valvular insufficiency (0.8%) and pericarditis (0.2%). Atrial fibrillation was the most common arrhythmia (75% of arrhythmias) with a prevalence rate of 5.6% in patients with BD. Among patients with BD, there was a trend towards higher mortality in patients with concomitant atrial fibrillation (6.1% vs 0.75, p=0.2). Myocardial infarction occurred at a significantly younger age in patients with BD compared to those without (53.9+/-14.1 years vs 68.6+/-13.9 years, p=0.006).
Conclusions
Patients with BD tend to be younger, white and female. Arrhythmias are the most common cardiovascular manifestation is patients with BD. Atrial fibrillation was the most common arrhythmia in patients with BD, and showed a trend towards higher mortality. MI occurred at a significantly younger age in patients with BD.