Mechanisms and Screening for Atherosclerosis in Adults With Vasculitis

Arterioscler Thromb Vasc Biol. 2025 Jan;45(1):3-10. doi: 10.1161/ATVBAHA.124.319982. Epub 2024 Nov 21.

Abstract

Vascular inflammation is a hallmark of both primary systemic vasculitis and atherosclerosis. As such, cardiovascular events are common in patients with vasculitis and likely due to both direct vascular inflammation and accelerated atherosclerosis. Direct cardiac involvement is possible in all vasculitides, though more commonly described in Takayasu arteritis, polyarteritis nodosa, and eosinophilic granulomatosis with polyangiitis. Accelerated atherosclerosis has been described in Takayasu arteritis and antineutrophil cytoplasmic antibody-associated vasculitis, though there remains a paucity of data in other forms of vasculitis. Multiple screening and management approaches for cardiovascular risk in people with vasculitis have been proposed, though evidence-based guidelines are lacking. In this review, we discuss the latest evidence in epidemiology, mechanisms, and screening for atherosclerosis in patients with primary systemic vasculitides.

Keywords: ANCA-associated vasculitides; Takayasu arteritis; atherosclerosis; cardiovascular diseases; coronary artery disease; vasculitis.

Publication types

  • Review

MeSH terms

  • Adult
  • Atherosclerosis* / diagnosis
  • Atherosclerosis* / epidemiology
  • Heart Disease Risk Factors
  • Humans
  • Mass Screening / methods
  • Predictive Value of Tests
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Vasculitis* / diagnosis
  • Vasculitis* / epidemiology