Evidence map›Paper›PMID 31846030›Full record

ArticleRheumatology (Oxford, England)2020

All-cause and cause-specific mortality in ANCA-associated vasculitis: overall and according to ANCA type.

Zachary S Wallace, Xiaoqing Fu, Tyler Harkness, John H Stone, Yuqing Zhang, Hyon Choi

Open access · greenAbstract readEvaluation Study
In one paragraph

Article in Rheumatology (Oxford, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 82 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
82citing papers in PubMed, 3 pooled it
8.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

82 citing papers in PubMed, 3 syntheses or guidelines pooled it, 131 citations in OpenAlex.

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22 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Zachary S WallaceClinical Epidemiology Program, Mongan Institute.
Xiaoqing FuClinical Epidemiology Program, Mongan Institute.
Tyler HarknessClinical Epidemiology Program, Mongan Institute.
John H StoneRheumatology Unit, Division of Rheumatology, Allergy, and Immunology, all at.
Yuqing ZhangClinical Epidemiology Program, Mongan Institute.
Hyon ChoiRheumatology Unit, Division of Rheumatology, Allergy, and Immunology, all at.
Harvard University · USMassachusetts General Hospital · US

Funding

Impact of ANCA Type and Rituximab vs. Cyclophosphamide on Cardiovascular Risk, Mortality, and Quality-Adjusted Life Years inANCA-Associated VasculitisK23AR073334 · NIAMS · MASSACHUSETTS GENERAL HOSPITAL · PI WALLACE, ZACHARY SCOTT · 2018 to 2022
$948k
NIAMS NIH HHS K23 AR073334NIAMS NIH HHS L30 AR070520
6 · The paper itself

Abstract

objectiveThe objective of this study was to evaluate causes of death in a contemporary inception cohort of ANCA-associated vasculitis patients, stratifying the analysis according to ANCA type.

methodsWe identified a consecutive inception cohort of patients newly diagnosed with ANCA-associated vasculitis from 2002 to 2017 in the Partners HealthCare System and determined vital status through the National Death Index. We determined cumulative mortality incidence and standardized mortality ratios (SMRs) compared with the general population. We compared MPO- and PR3-ANCA+ cases using Cox regression models.

resultsThe cohort included 484 patients with a mean diagnosis age of 58 years; 40% were male, 65% were MPO-ANCA+, and 65% had renal involvement. During 3385 person-years (PY) of follow-up, 130 patients died, yielding a mortality rate of 38.4/1000 PY and a SMR of 2.3 (95% CI: 1.9, 2.8). The most common causes of death were cardiovascular disease (CVD; cumulative incidence 7.1%), malignancy (5.9%) and infection (4.1%). The SMR for infection was greatest for both MPO- and PR3-ANCA+ patients (16.4 and 6.5). MPO-ANCA+ patients had an elevated SMR for CVD (3.0), respiratory disease (2.4) and renal disease (4.5). PR3- and MPO-ANCA+ patients had an elevated SMR for malignancy (3.7 and 2.7). Compared with PR3-ANCA+ patients, MPO-ANCA+ patients had a higher risk of CVD death [hazard ratio 5.0 (95% CI: 1.2, 21.2]; P = 0.03].

conclusionPremature ANCA-associated vasculitis mortality is explained by CVD, infection, malignancy, and renal death. CVD is the most common cause of death, but the largest excess mortality risk in PR3- and MPO-ANCA+ patients is associated with infection. MPO-ANCA+ patients are at higher risk of CVD death than PR3-ANCA+ patients.

Indexed as

AgedAntibodies, Antineutrophil CytoplasmicAnti-Neutrophil Cytoplasmic Antibody-Associated VasculitisCardiovascular DiseasesCause of DeathFemaleHumansKidney DiseasesMaleMiddle AgedMortality, PrematureNeoplasmsPeroxidaseProportional Hazards ModelsRetrospective StudiesAntibodies, Antineutrophil CytoplasmicMPO protein, humanPeroxidaseANCA-associated vasculitiscardiovascular diseasecause of deathmortality

Identifiers

PMID31846030
PMCPMC7449813
OpenAlexW2995886356

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.