TAKAYASU ARTERITIS AS A CAUSE OF ACUTE MYOCARDIAL INFARCTION (literature review)

Background. Takayasu arteritis (TAK) is a rare autoimmune vasculitis that primarily affects the aorta and its main branches, particularly the coronary arteries, which can significantly worsen a patient's prognosis. Undiagnosed TAK is common in young women and can lead to acute myocardial infarction (AMI), a potentially life-threatening condition. Aim. The aim of this review was to analyse current data on the incidence, clinical course, diagnosis, treatment and prognosis of patients with TAK and AMI. Increasing the awareness of general practitioners, cardiologists and rheumatologists about the importance of early recognition and treatment of patients with TAK and AMI will improve the prognosis of patients. Materials and methods. We performed the online literature search using PubMed and Scopus to collect articles on AMI in TAK published from 2013 to 2024 that were available in open access. The combinations of the following keywords “coronary angiography”, “myocardial infarction”, “myocardial revascularization”, “percutaneous coronary intervention”, and “Takayasu arteritis” were used. Two reviewers received and evaluated all articles independently. After excluding duplicates, all articles were checked for relevance. Articles without related content, studies on pediatric patients, in vitro studies, and experimental models were rejected as exclusion criteria. Results. TAK is a significant cause of AMI in young patients, particularly women, with an incidence of 3,4-34,0 %. Coronary artery lesions in TAK can result in sudden death, and AMI can be the first manifestation of TAK. The condition is characterized by lesions in the ostia and proximal segments of the coronary arteries. Early diagnosis and treatment, especially in young individuals with anginal pain and systemic inflammation, are essential to reduce morbidity and mortality. Conclusion. AMI can occur in young patients as a sight of systemic vasculitis, including TAK. TAK is a more frequent reason of AMI than recognized before, especially in young women. Coronary vasculitis, as an unrecognized sign of TAK, can be life-threatening. Early diagnosis and appropriate treatment, including immunosuppressive therapy, can prevent significant morbidity and mortality.