Population-Based Risk Factors for Ascending, Arch, Descending, and Abdominal Aortic Dilations for 60-74-Year-Old Individuals

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:78

Article

Obel, Lasse M.^1,2,3  Diederichsen, Axel C.^1,4  Steffensen, Flemming H.⁵  Frost, Lars⁶  Lambrechtsen, Jess⁷  Busk, Martin⁵  Urbonaviciene, Grazina⁶  Egstrup, Kenneth⁷  Karon, Marek⁸  Rasmussen, Lars M.^1,9  Gerke, Oke^3,10  Bovling, Anders S.^1,2,3  Lindholt, Jes S.^1,2 

[1] Odense Univ Hosp, Elitary Res Ctr CIMA, Odense, Denmark

[2] Odense Univ Hosp, Dept Cardiothorac & Vasc Surg, Sondre Blvd 29, DK-5000 Odense C, Denmark

[3] Univ Southern Denmark, Dept Clin Res, Odense, Denmark

[4] Odense Univ Hosp, Dept Cardiol, Odense, Denmark

[5] Vejle Hosp, Dept Cardiol, Vejle, Denmark

[6] Reg Hosp Silkeborg, Diagnost Ctr, Dept Cardiol, Silkeborg, Denmark

[7] Odense Univ Hosp, Dept Cardiol, Svendborg, Denmark

[8] Nykoebing Falster Hosp, Dept Med, Nykoebing Falster, Denmark

[9] Odense Univ Hosp, Dept Clin Biochem, Odense, Denmark

[10] Odense Univ Hosp, Dept Nucl Med, Odense, Denmark

关键词: abdominal and thoracic aorta;    aortic dilations and aneurysms;    epidemiology;    population-based;    prevalence;    risk factors;   

DOI  :  10.1016/j.jacc.2021.04.094

来源: Elsevier

【 摘 要 】

BACKGROUND Aortic dilations (ectasias and aneurysms) may occur on any segment of the aorta. Pathogenesis varies between locations, suggesting that etiology and risk factors may differ. Despite this discrepancy, guidelines recommend screening of the whole aorta if 1 segmental dilation is discovered. OBJECTIVES The purpose of this study was to determine the most dominant predictors for dilations at the ascending, arch, descending, and abdominal part of the aorta, and to establish comprehensive risk factor profiles for each aortic segment. METHODS Individuals aged 60-74 years were randomly selected to participate in DANCAVAS I & thorn;II (Danish Cardiovascular Multicenter Screening Trials). Participants underwent cardiovascular risk assessments, including blood samples, blood pressure readings, medical records, and noncontrast computed tomography scans. Adjusted odds ratios for potential risk factors of dilations were estimated by multivariate logistic analyses. RESULTS The study population consisted of 14,989 participants (14,235 men, 754 women) with an average age of 68 +/- 4 years. The highest adjusted odd ratios for having any aortic dilation were observed when coexisting aortic dilations were present. Other noteworthy predictors included coexisting iliac dilations, hypertension, increasing body surface area, male sex, familial disposition, and atrial fibrillation, which were present in various combinations for the different aortic parts. Smoking and acute myocardial infarction were inversely associated with ascending and abdominal dilations. Diabetes was a shared protective factor. CONCLUSIONS Risk factors differ for aortic dilations between locations. The most dominant predictor for having a dilation at any aortic segment is the presence of an aortic dilation elsewhere. This supports current guidelines when recommending a full screening of the aorta if a focal aortic dilation is discovered. (J Am Coll Cardiol 2021;78:201-11) (c) 2021 by the American College of Cardiology Foundation.

【 授权许可】

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