Clinical features, laboratory results, treatment responses and mortality evaluation in cardiac and vascular involvement of behçet's disease

Objective: In our study, it was aimed to evaluate the clinical features of patients who are being followed up with the diagnosis of Behçet's disease, to evaluate the frequency of cardiovascular involvement, localization, factors affecting the involvement, treatment responses, and to investigate the effect of cardiovascular involvement in Behçet's disease on the overall mortality of the disease. Materials and Methods: The information of Behçet patients who were being followed up at Karadeniz Technical University Faculty of Medicine Farabi Hospital between 2009-2019 was analyzed retrospectively. It was planned to include patients aged 18 and over who were diagnosed with Behçet's disease according to the International Study Group (ISG) criteria, and who could have access to complete blood count and biochemistry tests. Laboratory parameters were compared between the groups with and without cardiovascular system (CVS) involvement. The clinical features of Behçet patients with CVS involvement were examined in detail. Patients with CVS involvement were evaluated in terms of vascular attacks, anatomical involvement sites, laboratory parameters and treatments during the active attack period. In addition, the effect of KVS involvement on disease mortality was examined. Results: The data of 271 patients who were followed up with the diagnosis of Behçet's disease were analyzed. Among 271 patients included in the study, the number of patients with CVD involvement was 61 (22.5%). The number of male patients was significantly higher in those with CVS involvement (p <0.001). In Behçet patients with CVS involvement; leukocyte, neutrophil, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), erythrocyte sedimentation rate (ESR) and CRP levels were found to be significantly higher compared to Behçet patients without KVS involvement (p <0.001). After the first vascular attack, it was observed that immunosuppressive (IS) treatment was initiated in 47 patients (77%), anticoagulant (AC) treatment in 36 (59%) patients and IS + AC treatment in 25 (40.9%) patients. It was found that the development of vascular relapse was significantly higher in patients who received AC treatment only compared to those who received IS treatment only (p=0,009). Patients who only received IS treatment and received IS + AC combined treatment had similar effects when compared to the development of vascular relapse (p = 0.61). It was found that the mortality rate was significantly higher in patients with CVS involvement than those without (p = 0.002). When we look at the mortality development rates of patients with CVS involvement; The mortality rate in patients with arterial involvement was found to be significantly higher than those without involvement (p = 0.011). Conclusion: CVS involvement is extremely important in terms of morbidity and mortality in Behçet patients; NLR, ESR, CRP levels may be suggestive in order to predict the involvement in patients with active disease. In CVS involvement, the mortality rate of arterial involvement is higher than that of venous involvement; close monitoring of patients with arterial involvement is of great importance. In addition, in patients with KVS involvement; there was no statistically significant benefit of adding AC therapy to IS treatment in preventing the development of new attacks. Key words: Behçet's disease, vascular involvement, mortality, treatment