Treatment with Corticosteroid and/or Immunosuppressive Agents before Surgery can Effectively Improve the Surgical Outcome in Patients with Takayasu's Arteritis

ABSTRACT

Objective: To analyze the clinical outcome of corticosteroid and/or immunosuppressive treatment preoperatively in patients with Takayasu's arteritis. Patients and Methods: Forty-six patients with Takayasu's arteritis who received cardiovascular surgery between January 2010 and December 2015 in Beijing Anzhen Hospital were enrolled in this study. Their clinical characteristics, preoperative drug therapy, surgical treatment, and pathological examination results were retrospectively analyzed for the effect of drugs on outcome of the surgery. Results: All 8 patients with active disease prior to surgery had postoperative complications including one death due to stubborn perivalvular regurgitation induced heart failure during the perioperative period. Among 38 patients without active disease prior to surgery, only 4 patients (10.5%) had postoperative complications. Thirty-four patients showed symptomatic relief in the perioperative period, of whom 23 patients treated with corticosteroid and/or immunosuppressive agents preoperatively. Conclusion: The surgery can effectively improve the symptoms of patients with Takayasu's arteritis. Active disease of Takayasu's arteritis markedly increased risk for postoperative complication and resulted in poor outcome of the surgery. Treatment with corticosteroid and/or immunosuppressive agents before surgery can effectively control the patient's condition, improve the rate of remission, and effectively reduce the incidence of postoperative complications.

Keywords::

• Takayasu's arteritis
• cardiac surgery
• corticosteroid treatment
• postoperative complications
• immunosuppressive agents
• remission

CONFLICT OF INTEREST

The authors report no conflicts of interest.

AUTHOR CONTRIBUTION STATEMENT

Tie Zheng, Shuai Zhu, Xue-Jun Sun and Jun-Ming Zhu equally contributed to the conception and design of the research; Wei-Gang Fang and Zhi-Yu Qiao contributed to the design of the research; Jia-Fu Ou, Li Chen, Qing Zhu, Li-Li Pan and Rui-Dong Qi contributed to the acquisition and analysis of the data; Lei Chen, Cheng-Nan Li and Dong Chen contributed to the interpretation of the data; and Tie Zheng and Xue-Jun Sun drafted the manuscript. All authors critically revised the manuscript, agree to be fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript.

Additional information

Funding

This study was supported by Health from National Health and Family planning Commission of China (No. 201402009) and The National Key Technology R&D Program (No. 2015BAI12B03).