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J. F. Bacon, E. Sharkawi, G. Plant; Aspirin Treatment in Giant Cell Arteritis Patients. A UK Study. Invest. Ophthalmol. Vis. Sci. 2007;48(13):922.
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Giant cell arteritis (GCA) is often complicated by irreversible ocular and cerebrovascular ischemic events. Recent retrospective studies have suggested aspirin may be effective in reducing the risk of cranial ischemic complications in patients with GCA. Characteristically, ischemic events are thought to be due to stenosis rather than thromboembolism.We set out to ascertain whether aspirin reduces cranial ischemic complications in patients with GCA.
The medical notes of a consecutive series of 124 patients with GCA were reviewed in 3 UK centers. Diagnosis was made using biopsy results and the modified criteria of the American College of Rheumatology for GCA. Data included patient demographics, cardiovascular risk factors, drug therapies, ischemic complications and hemorrhagic events.
A total of 124 patients (108 biopsy positive) were identified, 33% were male. Mean age was 75. 31 patients were taking anti-platelet agents at presentation, 8 patients were started on these after diagnosis. 58 (62%) of 93 patients not on antiplatelet drugs developed ischemic complications, compared with 16 (70%) of 23 patients on aspirin. One patient not on aspirin developed a hemorrhagic complication.
In contrast to recent studies, our results revealed no difference in ischemic complications between GCA patients on aspirin and those not on antiplatelet treatment. This is in keeping with the lack of thrombus in biopsy specimens and illustrates the need for a prospective randomised controlled trial to establish the effects of antiplatelet therapy in GCA.
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