Risk Factors and Pharmacological Interventions Impacting Cerebrovascular Ischemic Events in Giant Cell Arteritis: A Narrative Review

Abstract Giant cell arteritis (GCA) is a prevalent vasculitis primarily affecting larger vessels, notably in individuals aged 70–79. Cerebrovascular ischemic events (CIE), such as stroke and transient ischemic attacks, are significant GCA complications, with a pooled prevalence of 4%. CIEs are rare but debilitating complications of GCA. This research article is a narrative review that aims to highlight the risk factors and pharmacological interventions that impact GCA-related CIE. This narrative review suggests that age, male gender, hypertension, and smoking were significantly associated with GCA-related CIE, while risk factors such as having anemia, a higher body mass index (BMI), relatively higher inflammatory markers such as C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) had protective effects against GCA-related CIE. Symptoms of ischemia of the ophthalmic artery were also found to be the strongest predictors of CIE. Pharmacological interventions such as glucocorticoids and tocilizumab can help manage and prevent CIE in GCA patients. Aspirin and antiplatelet therapy may also be useful as adjunctive therapies. A detailed and appropriate study design for various risk factors is required to establish the association. Identifying risk factors is imperative for managing morbidity and mortality. This can help physicians assess the risk and prevent CIE in GCA patients.