The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Increased Incidence of Aortic Aneurysm and Dissection in Giant Cell (Temporal) Arteritis: A Population-Based Study

Jonathan M. Evans, MD; W. Michael O'Fallon, PhD; and Gene G. Hunder, MD
[+] Article, Author, and Disclosure Information

From the Mayo Clinic, Rochester, Minnesota. Requests for Reprints: Gene G. Hunder, MD, Division of Rheumatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. Acknowledgments: The authors thank Ms. Debra Peterson for assistance in manuscript preparation.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1995;122(7):502-507. doi:10.7326/0003-4819-122-7-199504010-00004
Text Size: A A A

Objective: To determine the frequency of aneurysm and dissection of the aorta in patients with giant cell arteritis and to assess the effects of these events on these patients.

Design: Population-based cohort study.

Setting: A multispecialty and a primary care clinic in southern Minnesota.

Patients: 96 residents of Olmsted County, Minnesota, who developed giant cell arteritis between 1950 and 1985. The presence of aortic aneurysm, dissection, or both was confirmed using computed tomography, ultrasonography, angiography, or autopsy.

Results: 11 of the 96 patients were found to have thoracic aortic aneurysms. In 2 of these patients, the aneurysms were detected when giant cell arteritis was diagnosed. In the remaining 9 patients, the aneurysms occurred a median of 5.8 years after giant cell arteritis was diagnosed. Six of the 11 died suddenly of acute thoracic aortic dissection. Five patients who did not have thoracic aortic aneurysms developed isolated abdominal aortic aneurysms a median of 2.5 years after giant cell arteritis was diagnosed. The incidence of thoracic aortic aneurysm in patients with giant cell arteritis was 999 per 100 000 person-years; the incidence of abdominal aortic aneurysm in these patients was 555 per 100 000 person-years.

Compared with all persons of the same age and sex living in Olmsted County, patients with giant cell arteritis were 17.3 times (95% CI, 7.9 to 33.0) more likely to develop thoracic aortic aneurysm and 2.4 times (CI, 0.8 to 5.5) more likely to develop isolated abdominal aortic aneurysm.

Conclusions: Giant cell arteritis is associated with a markedly increased risk for the development of aortic aneurysm, which is often a late complication and may cause death.


Grahic Jump Location
Figure 1.
Chest radiograph of patient 6 (see Table 2) showing a thoracic aortic aneurysm found 7.5 years after diagnosis of giant cell arteritis


Grahic Jump Location
Grahic Jump Location
Figure 2.
Computed tomographic scan of chest of patient 8 (seeTable 2) showing section including a thoracic aortic aneurysm.

Ascending portion of the thoracic aorta (large arrow) is more dilated than the descending portion (small arrow).

Grahic Jump Location
Grahic Jump Location
Figure 3.
Survival in 96 patients with giant cell arteritis compared with the expected survival rates among whites.

Data obtained from the United States Life-Table of 1980. GCA = giant cell arteritis.

Grahic Jump Location




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.