Aneurysm Global Epidemiology Study

Sidloff, David; Stather, P.W.; Dattani, Nikesh; Bown, Matthew J.; Thompson, John R.; Sayers, Robert D.; Choke, Edward

doi:10.1161/circulationaha.113.005457

Cited by 178 publications

(70 citation statements)

References 33 publications

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“…9 However, in a recent report, the same investigators found a very similar inverse association between body mass index and abdominal aortic aneurysms, 10 suggesting that this finding is reproducible. However, a causal explanation is elusive, so, for now, we may consider this to be yet another example of the apparent "obesity paradox.…”

Section: Article See P 2287mentioning

confidence: 85%

“…In fact, in contradistinction, in a cross-sectional population of subjects without known thoracic aortic disease, body mass index was positively associated with aortic root diameter. 9 However, in a recent report, the same investigators found a very similar inverse association between body mass index and abdominal aortic aneurysms, 10 suggesting that this finding is reproducible. However, a causal explanation is elusive, so, for now, we may consider this to be yet another example of the apparent "obesity paradox."…”

Section: Article See P 2287mentioning

confidence: 89%

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Trends in Thoracic Aortic Aneurysms and Dissection

Isselbacher

2014

Circulation

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Editorial 2267I n this issue of Circulation, Sidloff and colleagues 1 have presented their findings that, among 18 World Health Organization member states over a period of 16 years (1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010), there has been a reduction in the age-standardized mortality from both thoracic aortic aneurysm and dissection. If one considers the United States, the United Kingdom, and Sweden, 3 countries that have published extensively on the prevalence and mortality of thoracic aortic disease, the trends are quite favorable: Mortality from thoracic aortic aneurysm has declined by ≈5% to 10% among men and 3% to 6% among women, and mortality from aortic dissection has declined by ≈2% to 3% among men and 1% to 2% among women. However, and not surprisingly, the investigators discovered heterogeneity among mortality trends by country. For example, for men with thoracic aortic aneurysms, although there was a statistically significant reduction in mortality over time in 13 of the 18 countries, in 3 countries, there was instead an increase in mortality. Similarly, for men suffering from aortic dissection, although there was again a statistically significant reduction in mortality over time in 13 of the 18 countries, in 1 country, there was a significant rise in mortality. Japan and Romania were the 2 countries with the most consistent increases in mortality. Article see p 2287The investigators then considered the impact of changing prevalence of risk factors on the changing mortality from thoracic aortic disease. In all of the countries studied, there was a decline in systolic blood pressure of up to 6% over time, and there was a linear relationship between systolic blood pressure and mortality from both thoracic aortic aneurysm and dissection. This makes good mechanistic sense given the known association between hypertension and both aneurysms and dissection.In all countries but Japan, there was a decline in cholesterol levels over time, and the investigators also found a linear relationship between cholesterol and mortality from thoracic aortic aneurysm. At first, it may seem logical that a reduction in cholesterol would result in a reduction in death caused by thoracic aortic disease because hyperlipidemia is a well-known cardiovascular risk factor. Moreover, atherosclerosis has been found to be strongly associated with abdominal aortic aneurysms, although whether this association is causative remains unclear.2 However, the evidence actually indicates that atherosclerosis is negatively rather than positively associated with thoracic aortic aneurysms.3 So how might the apparent association between the downward trends in both cholesterol and thoracic aortic aneurysm mortality be explained? One possibility, albeit unlikely, is that, despite the negative association between atherosclerosis and thoracic aneurysms, there is an independent and positive association with cholesterol itself and thoracic aortic aneurysm. An alternative, and far more plausible...

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Section: Article See P 2287mentioning

confidence: 85%

Section: Article See P 2287mentioning

confidence: 89%

Trends in Thoracic Aortic Aneurysms and Dissection

Isselbacher

2014

Circulation

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“…AAA prevalence increases with age, and even though the incidence has declined in the past ten years [14], rupture of AAA is still a significant cause of death with 10–15% of AAAs presenting as ruptured AAAs (rAAA) in the emergency room. AAA rupture risk increases with increasing aortic diameter and this catastrophic event is associated with a mortality of 50 to 80% [15–17].…”

Section: Clinical Studies On Aaamentioning

confidence: 99%

Update on Abdominal Aortic Aneurysm Research: From Clinical to Genetic Studies

et al. 2014

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An abdominal aortic aneurysm (AAA) is a dilatation of the abdominal aorta with a diameter of at least 3.0 cm. AAAs are often asymptomatic and are discovered as incidental findings in imaging studies or when the AAA ruptures leading to a medical emergency. AAAs are more common in males than females, in individuals of European ancestry, and in those over 65 years of age. Smoking is the most important environmental risk factor. In addition, a positive family history of AAA increases the person's risk for AAA. Interestingly, diabetes has been shown to be a protective factor for AAA in many large studies. Hallmarks of AAA pathogenesis include inflammation, vascular smooth muscle cell apoptosis, extracellular matrix degradation, and oxidative stress. Autoimmunity may also play a role in AAA development and progression. In this Outlook paper, we summarize our recent studies on AAA including clinical studies related to surgical repair of AAA and genetic risk factor and large-scale gene expression studies. We conclude with a discussion on our research projects using large data sets available through electronic medical records and biobanks.

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“…The risk of AAA rupture is determined by size; specifically, rupture occurs in approximately 2% of AAAs less than 4 cm in diameter and in more than 25% of AAAs larger than 5 cm. Surgical repair is indicated for large AAAs (diameter > 5.5 cm) or if the growth rate exceeds 1 cm/year [5]. …”

Section: Introductionmentioning

confidence: 99%

Association between Atrial Fibrillation and Aortic Aneurysms: A Population-Based Cohort Study

et al. 2018

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Objective: Atrial fibrillation (AF) is the most common form of sustained arrhythmia. Several molecular pathways associated with the pathogenesis of AF also participate in the initiation and progression of aortic aneurysm (AA). In this study, we aimed to evaluate potential associations between AA and AF. Patients and Methods: The data for this nationwide population-based retrospective cohort study were obtained from Taiwan’s National Health Insurance Research Database (NHIRD). All medical conditions for each case and the controls were categorized using the 9th revision of the International Classification of Diseases (ICD-9). Odds ratios and 95% confidence intervals for associations between AF and AA were estimated using Cox regression and adjusted for comorbidities. Results: Our analyses included 116,225 AF cases and 116,225 propensity score-matched controls. Compared with the controls, the patients with AF exhibited a significantly increased risk of developing an AA (adjusted hazard ratio, HR 1.243, p < 0.001). Another cohort of 19,776 patients diagnosed with AA were identified, and 19,776 propensity score-matched patients were included as controls. Patients who had AA were also at an increased risk of developing AF (adjusted HR 1.187, p < 0.001). Heart failure (HF) was a common risk factor for both AA and AF. Conclusion: There are associations between AF and AA. HF is a mutual risk factor for the development of AF and AA.

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Aneurysm Global Epidemiology Study

Cited by 178 publications

References 33 publications

Trends in Thoracic Aortic Aneurysms and Dissection

Trends in Thoracic Aortic Aneurysms and Dissection

Update on Abdominal Aortic Aneurysm Research: From Clinical to Genetic Studies

Association between Atrial Fibrillation and Aortic Aneurysms: A Population-Based Cohort Study

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