Table 2 Main characteristics of studies in the prevalence meta-analysis
First author | Country | Year | Study design | Study period | GCA diagnosis criteria | GCA-related cerebrovascular ischemic event (CIE) definition | Population | Number of GCA-related CIE | Prevalence |
|---|---|---|---|---|---|---|---|---|---|
Berger [9] | Switzerland | 2009 | Retrospective | 10 years (1997–2007) | Biopsy-proven GCA and/or ACR criteria (≥ 3/5) | If occurring within 2 weeks of diagnosis. TIA were excluded | 85 | 2 | 2.35% |
Cid [7] | Spain | 1998 | Retrospective | 16 years | Biopsy-proven GCA | If they were concomitant with disease manifestations and in the absence of significant vascular risk factors such as heavy smoking, hypertension, hypercholesterolemia, or diabetes | 200 | 3 | 1.50% |
Coronel [18] | Spain | 2021 | Retrospective | 11 years (2005–2016) | ACR criteria (≥ 3/5). Diagnosis based on the patient’s clinical history, blood tests and imaging results | If occurring during the first 4 weeks following diagnosis or relapse of GCA. CTA were run on all patients and the information of all MRA studies available was recorded, to rule out other etiologies such as atherosclerosis, arrhythmia, bleeding and others causes | 123 | 9 | 7.32% |
De Boysson [15] | France | 2017 | Retrospective | 20 years (1995–2015) | ACR criteria (≥ 3/5) | If occurring at the time of diagnosis or within 4 weeks after starting GCA therapy. TIA were excluded | 876 | 35 | 4.00% |
Gonzalez-Gay [11] | Spain | 2009 | Retrospective | 27 years (1981–2008) | Biopsy-proven GCA | If occurring between the onset of symptoms of the disease and 4 weeks after the onset of steroid therapy. All patients in whom stroke was diagnosed had lesions on CTA and/or MRA that were read by a neuroradiologist and correlated clinically by a neurologist. TIA were excluded | 287 | 8 | 2.79% |
Hočevar [20] | Slovenia | 2020 | Prospective | 8 years (2011–2019) | Corresponding clinical and laboratory features, and a positive result of a TAB, or CDS or PET/CT | If occurring after the onset of GCA symptoms and up to 1 month after the initiation of glucocorticoid therapy. TIA were excluded | 295 | 9 | 3.05% |
Lee [13] | USA | 2006 | Retrospective | 15 years (1989–2004) | ACR criteria (≥ 3/5) | If other signs, symptoms, or laboratory evidence of a recurrence was present. Hemispheric strokes only were included. TIA were excluded | 143 | 6 | 4.20% |
Narváez [16] | Spain | 2008 | Retrospective | 18 years (1986–2004) | Biopsy-proven GCA and/or ACR criteria (≥ 3/5) | If occurring within the time between the onset of GCA symptoms and 4 weeks after the onset of corticosteroid therapy | 121 | 5 | 4.13% |
Nesher [19] | Israel | 2004 | Retrospective | 20 years (1980–2000) | Biopsy-proven GCA and/or ACR criteria (≥ 3/5) | If occurring at presentation or within 2 weeks of GCA diagnosis. Strokes developing later were considered GCA related only when associated with at least 1 of the other GCA-related signs or symptoms, or laboratory evidence of acute-phase reaction. TIA were excluded | 175 | 19 | 10.86% |
Pariente [17] | France | 2019 | Retrospective | 8 years (2010–2018) | ACR criteria (≥ 3/5) | If occurring within a delay between GCA diagnosis and stroke inferior to 12 months, and with no other etiology of stroke, notably the absence of atrial fibrillation at the time of stroke | 139 | 18 | 12.95% |
Parreau [14] | France | 2022 | Retrospective | 38 years (1982–2020) | ACR criteria (≥ 3/5). In biopsy-negative cases, if at least 3 criteria fulfilled, or if only 2 criteria fulfilled with PET/CT or CTA strongly suggestive of vasculitis | If occurring at the time of diagnosis or within 4 weeks of starting GCA treatment. If the neurological event preceded GCA diagnosis, a review of neurovascular imaging charts allowed to recognize retrospectively GCA-related CIE. Strokes without concurrent atrial fibrillation occurring during GCA flare were also regarded as GCA-related. TIA were excluded | 560 | 19 | 3.39% |
Penet (present study) | France | 2022 | Retrospective | 11 years (2010–2020) | ACR criteria (≥ 3/5) | If it was clearly linked to GCA at diagnosis or relapse after reviewing patient's medical records, in the absence of another well identified etiology (mainly atherosclerosis, embolic or cerebral small vessel disease) | 271 | 14 | 5.17% |
Salvarani [8] | Italy | 2009 | Retrospective | 19 years (1986–2005) | Biopsy-proven GCA | If occurring within the time between the onset of GCA symptoms and 4 weeks after the onset of corticosteroid therapy | 180 | 5 | 2.78% |
Zenone [10] | France | 2013 | Retrospective | 12 years (1999–2012) | ACR criteria (≥ 3/5) | Doppler US or MRA of the supra-aortic vessels performed in order to demonstrate concentric segmental narrowing, stenosis and/or occlusions suggestive of vasculitis | 98 | 6 | 6.12% |