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East Florida


HCA Florida Aventura Hospital


Transitional Year

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Publication Date



veterans, giant cell arteritis, vasculitis, temporal artery biopsy, TAB


Cardiovascular Diseases | Medicine and Health Sciences | Nervous System Diseases


Please see supplemental content for full abstract with references.

Introduction: Giant cell arteritis (GCA) is the most common primary systemic vasculitis in adults, but studies to date have been limited in volume or subject to retrospective meta-analysis.1 The United States Veterans Health Administration (VHA) holds the nation’s largest electronic medical database. Veterans comprise 7% of the American population, including 24% of the population over 75 years old.2 Building upon a clinical study of one VHA site cohort,3 we used this database to identify differences in demographics, risk factors, associated systemic conditions, and biopsy yield within the entire veteran population using novel methodology.

Methods: This retrospective cohort study included 24,857 individuals with codes for GCA or temporal artery biopsy (TAB) since 1/1/2001 within the VA Informatics and Computing Infrastructure (VINCI) database. Patients with diagnosis codes for GCA given within 14-60 days after completion of TAB were considered positive for the disease. Unadjusted odds ratios were used as the measure of association between TAB results and clinical variables, including demographic (e.g., age at diagnosis, geographic region, and gender) and 18 medical comorbidities seen in GCA patients.

Results: Of 10,470 patients with a documented TAB procedure, 2285 were positive (21.8%). Mean age at diagnosis was 72.9 (95% CI [72.5, 73.3]) years, with highest prevalence between 70-79 (828 patients, 36.4%). Mean age at diagnosis was higher in males (73.2, 95% CI [72.8-73.6]) versus females (68.1 [66.3-69.9]), and odds of positive TAB were higher in males than females (OR 1.26 [1.04-1.52]). Odds of GCA were higher in patients with polymyalgia rheumatica (OR 2.05 [1.82-2.31]), aortic aneurysm dissection (OR 1.17 [1.02-1.34]), and amaurosis fugax (OR 1.12 [0.96-1.31]).

Conclusion: Our findings identify several clinical factors associated with positive and negative TAB results within the VHA and is the largest study to date on this disease.

Diagnostic Considerations of Giant Cell Arteritis in Veterans



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