Racial differences in stroke, blindness, and mortality among Black versus non-Black patients with giant cell arteritis: an international cohort study

Objective To explore potential racial differences in vascular, visual, and systemic outcomes among Black and non-Black patients with giant cell arteritis (GCA). Design A retrospective cohort study using the TriNetX global database. Participants 30,513 patients diagnosed with GCA, including 3 068 Black (10.1%) and 27,445 non-Black (89.9%) patients. After propensity score matching, 3 022 patients were included in each group. Methods A propensity score-matched analysis was conducted to compare the risks of stroke, ischemic optic neuropathy (ION), visual defects/blindness, emergency department (ED) visits, myocardial infarction (MI), aortic aneurysm/dissection, and death at 6-month and 1-year follow-ups. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated. Results Black patients appeared to have a higher likelihood of stroke at 6 months (HR 1.33, 95% CI: 1.07–1.65) and 1 year (HR 1.38, 95% CI: 1.13–1.69), as well as more ED visits at 6 months (HR 1.29, 95% CI: 1.17–1.42) and 1 year (HR 1.29, 95% CI: 1.18–1.41) compared to non-Black patients. In contrast, Black patients had a lower likelihood of ION at 6 months (HR 0.60, 95% CI: 0.43–0.85) and 1 year (HR 0.59, 95% CI: 0.42–0.82). No notable differences were observed in MI, visual defects/blindness, aortic aneurysm/dissection, or death. Conclusions These findings suggest potential racial differences in GCA-related outcomes, with Black patients experiencing a higher likelihood of stroke and ED visits but a lower likelihood of ION. Further research is needed to better understand the underlying factors contributing to these differences and to ensure equitable care for all patients with GCA.