Patients with giant cell arteritis (GCA) represent an extremely fragile population. This frailty arises from the combination of a chronic, highly inflammatory disease affecting patients invariably older than 50 years of age and long-term use of drugs with extensive metabolic side effects such as glucocorticoids [ [1] Salvarani C. Cantini F. Hunder G.G. Polymyalgia rheumatica and giant-cell arteritis.

The Lancet. 2008; 372: 234-245

, [2] Albrecht K. Huscher D. Buttgereit F. Aringer M. Hoese G. Ochs W. et al. Long-term glucocorticoid treatment in patients with polymyalgia rheumatica, giant cell arteritis, or both diseases: results from a national rheumatology database.

Rheumatol Int. 2018; 38: 569-577

]. For this reason, management of GCA patients should not only aim at the symptomatic treatment of inflammatory manifestations and the prevention of short and long-term disease-related complications (i.e., sight loss, aortic aneurysms) [ [3] Patil P. Williams M. Maw W.W. Achilleos K. Elsideeg S. Dejaco C. et al. Fast track pathway reduces sight loss in giant cell arteritis: results of a longitudinal observational cohort study.

Clin Exp Rheumatol. 2015; 33

, [4] Jud P. Verheyen N. Dejaco C. Haas E. Szolar D. Meinitzer A. et al. Prevalence and prognostic factors for aortic dilatation in giant cell arteritis – a longitudinal study.

Semin Arthritis Rheum. 2020; (S0049-0172(20)30278-X)

], but should always be weighted in order to minimize the potential treatment-related adverse events. It is now well established that GCA carries an increased risk of osteoporosis, type II diabetes mellitus, and severe infections, but also of cerebrovascular and cardiovascular complications [ 5 Paskins Z. Whittle R. Sultan A.A. Muller S. Blagojevic-Bucknall M. Helliwell T. et al. Risk of fracture among patients with polymyalgia rheumatica and giant cell arteritis: a population-based study.

BMC Med. 2018; 16: 4

, 6 Faurschou M. Ahlstrom M.G. Lindhardsen J. Obel N. Baslund B. Risk of diabetes mellitus among patients diagnosed with giant cell arteritis or granulomatosis with polyangiitis: comparison with the general population.

J Rheumatol. 2017; 44: 78-83

, 7 Schmidt J. Smail A. Roche B. Gay P. Salle V. Pellet H. et al. Incidence of severe infections and infection-related mortality during the course of giant cell arteritis: a multicenter, prospective, double-cohort study.

Arthritis Rheumatol. 2016; 68: 1477-1482

, 8 Samson M. Jacquin A. Audia S. Daubail B. Devilliers H. Petrella T. et al. Stroke associated with giant cell arteritis: a population-based study.

J Neurol Neurosurg Psychiatry. 2015; 86: 216-221

]. Although the incidence of cardiovascular events (particularly, of myocardial infarction (MI)) in GCA patients has been already extensively reported by different groups to be higher than in the general population [ 9 Amiri N. De Vera M. Choi H.K. Sayre E.C. Avina-Zubieta J.A Increased risk of cardiovascular disease in giant cell arteritis: a general population-based study.

Rheumatology. 2016; 55: 33-40

, 10 Giant cell arteritis and vascular disease-risk factors and outcomes: a cohort study using UK Clinical Practice Research Datalink.

Rheumatology. 2017; 56: 753-762

, 11 Tomasson G. Peloquin C. Mohammad A. Love T.J. Zhang Y. Choi H.K. et al. Risk for cardiovascular disease early and late after a diagnosis of giant-cell arteritis: a cohort study.

Ann Intern Med. 2014; 160: 73-80

, 12 Udayakumar P.D. Chandran A.K. Crowson C.S. Warrington K.J. Matteson E.L. Cardiovascular risk and acute coronary syndrome in giant cell arteritis: a population-based retrospective cohort study.

Arthritis Care Res. 2015; 67: 396-402

], a characterization of the features of MI in this group of patients was missing.