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Prevalence of aortic aneurysms and dissections in patients with systemic vessel aneurysms and dissections; matched
Jihye Song1, Yong Cheol Lim1, Do Jung Kim2
1Department of Neurosurgery, Ajou University School of Medicine, Ajou University Hospital, Suwon, Republic of Korea.
Insights
Patients with other systemic vessel aneurysms and dissections (OVAD) have a 37.56 times higher prevalence of aortic aneurysms and dissections (AAD). This suggests viewing aneurysms as systemic diseases for better understanding and treatment.
Area of Science:
- Vascular Surgery
- Cardiovascular Research
- Epidemiology
Background:
- Aneurysms in systemic arteries are rare, with limited understanding of their connection to aortic aneurysms.
- Aortic aneurysms and dissections (AAD) and other systemic vessel aneurysms and dissections (OVAD) are distinct but potentially related vascular conditions.
Purpose of the Study:
- To evaluate the prevalence of AAD in patients diagnosed with OVAD.
- To identify potential risk factors associated with the co-occurrence of AAD and OVAD.
Main Methods:
- A cross-sectional study utilizing a nationwide representative cohort from the Korea National Health Insurance Service-National Sample Cohort database.
- Defined OVAD as aneurysms and dissections in systemic vessels, excluding those in the brain and aorta.
- Compared 690 OVAD patients with 2,760 matched non-OVAD controls, using chi-squared tests and logistic regression for analysis.
Main Results:
- The prevalence of AAD was significantly higher in the OVAD group (10.6%) compared to the non-OVAD group (0.3%).
- Patients with OVAD had an adjusted odds ratio of 37.56 for concurrent AAD.
- Higher adjusted odds ratios for AAD were observed in females, individuals aged 60 years and older, and those without hypertension, diabetes mellitus, or dyslipidemia. AAD prevalence also varied significantly by the specific site of OVAD.
Conclusions:
- The study highlights a substantially increased prevalence of AAD in patients with OVAD, suggesting aneurysms may be systemic diseases.
- Further research into the pathophysiology of aneurysms is warranted to elucidate the relationship between AAD and OVAD.
Objective:
Aneurysms in systemic arteries are rare, and little is known about their relationship with aortic aneurysms. In this study, we aimed to evaluate the prevalence of aortic aneurysms and dissections (AAD) in patients with other systemic vessel aneurysms and dissections (OVAD) and identify their potential risk factors.
Methods:
This cross-sectional study used a nationwide representative cohort sample from the Korea National Health Insurance Service-National Sample Cohort database. We defined OVAD as systemic vessel aneurysms and dissections excluding intracranial and aortic dissections and aneurysms. With a total of 690 OVAD patients and 2,760 non-OVAD matched controls, we investigated the prevalence of AAD in patients with OVAD and potential risk factors for their concurrence using the χ2 test and logistic regression.
Results:
The prevalence of AAD in patients with OVAD was 10.6% (73/690) and 0.3% (9/2,760) in patients with non-OVAD. The adjusted odds ratio (OR) for having concurrent AAD with OVAD was 37.56 (95% CI: 18.29-77.12, p < 0.001) after stratification by sex, age, income, region of residence and after adjustment for hypertension, diabetes mellitus, dyslipidemia, and extent of disability. The adjusted ORs of AAD were significantly higher in females [adjusted OR = 47.63 (95% CI: 10.72-211.55)], and individuals aged ≥60 years [adjusted OR = 28.18 (95% CI: 13.42-59.17)], as well as those without hypertension [adjusted OR = 95.44 (95% CI: 18.21-500.23)], diabetes mellitus [adjusted OR = 46.39 (95% CI: 18.85-114.17)], without dyslipidemia [adjusted OR = 60.99 (95% CI: 20.83-178.56), p < 0.001 for all]. The prevalence of AAD significantly differed by according to specific sites of OVAD in carotid artery, upper extremity artery, iliac artery, lower extremity artery, and splanchnic artery (p < 0.001 for all).
Conclusions:
The prevalence of AAD in patients with OVAD was 37.56 times higher than that in the matched population. We may approach aneurysms as systemic diseases and further investigations of pathophysiology would help to clarify the relationships between AAD and OVAD.
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