ADAB2IPgenotype: sex interaction is associated with abdominal aortic aneurysm expansion

2017 ◽  
Vol 65 (7) ◽  
pp. 1077-1082 ◽  
Author(s):  
Zi Ye ◽  
Erin Austin ◽  
Daniel J Schaid ◽  
Kent R Bailey ◽  
Patricia A Pellikka ◽  
...  
Keyword(s):  
Growth Rate ◽  
Sex Differences ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Genetic Variants ◽  
Diabetic Status ◽  
Abdominal Aortic ◽  
Increased Risk ◽  
Risk Of Rupture ◽  
Full Factorial

A faster expansion rate of abdominal aortic aneurysm (AAA) increases the risk of rupture. Women are at higher risk of rupture than men, but the mechanisms underlying this increased risk are unknown. We investigated whether genetic variants that influence susceptibility for AAA (CDKN2A-2B,SORT1,DAB2IP,LRP1andLDLR) are associated with AAA expansion and whether these associations differ by sex in 650 patients with AAA (mean age 70±8 years, 17% women) enrolled in the Mayo Clinic Vascular Disease Biorepository. Women had a mean aneurysm expansion 0.41 mm/year greater than men after adjustment for baseline AAA size. In addition to baseline size, mean arterial pressure (MAP), non-diabetic status,SORT1-rs599839[G] andDAB2IP-rs7025486[A] were associated with greater aneurysm expansion (all p<0.05). The associations of MAP and rs599839[G] were similar in both sexes, while the associations of baseline size, pulse pressure (PP) and rs7025486[A] were stronger in women than men (all p-sexinteraction≤0.02). A three-way interaction of PP*sex* rs7025486[A] was noted in a full-factorial analysis (p=0.007) independent of baseline size and MAP. In the high PP group (≥median), women had a mean growth rate 0.68 mm/year greater per [A] of rs7025486 than men (p-sexinteraction=0.003), whereas there was no difference in the low PP group (p-sexinteraction=0.8). We demonstrate that variantsDAB2IP-rs7025486[A] andSORT1-rs599839[G] are associated with AAA expansion. The association of rs7025486[A] is stronger in women than men and amplified by high PP, contributing to sex differences in aneurysm expansion.

Abstract 489: A Data Driven Approach to Identify Subtypes of Abdominal Aortic Aneurysm With Distinct Clinical and Genetic Characteristics

2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Zi Ye ◽  
Erin Austin ◽  
Iftikhar Kullo
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Genetic Variants ◽  
Odds Ratio ◽  
Atherosclerotic Cardiovascular Disease ◽  
Thyroid Disorder ◽  
Genetic Characteristics ◽  
Abdominal Aortic ◽  
Increased Risk ◽  
All Cause Mortality

Background: Abdominal aortic aneurysm (AAA) is a complex and heterogeneous disorder. We hypothesized that dense phenomapping using electronic health records (EHR) can identify subtypes of AAA with distinct clinical and genetic characteristics. Methods & Results: AAA cases (n=1108) and controls (n=4694) were identified from the Mayo vascular disease biorepository and had available high-density genotyping data. 132 Candidate genetic variants (p < 10E-5) associated with atherosclerotic cardiovascular disease (ASCVD) or AAA were selected from GWAS catalog. Using model-based Gaussian-mixture cluster analysis of 46 clinical features from 6 data domains, 24 data elements, 204 variables (including age, sex, vital signs, laboratory data, medication use, family history), spanning over 20 years of observational time in the EHR, we identified two subtypes of AAA: subtype 1(S1, n=421) with faster AAA growth rate (baseline size adjusted mean difference, 95% CI: 0.013, 0.001 to 0.020 cm / year faster, p = 0.03), higher all-cause mortality (age & sex adjusted hazard ratio, 95% CI: 1.36, 1.09 - 1.70, p < 0.01) than subtype 2 (S2, n=687). As compared with the controls, thyroid disorder / rheumatoid or osteoarthritis / infectious conditions were uniquely associated with increased odds ratio for S1; ASCVD / hyperlipidemia / hypertension were uniquely associated with increased odds ratio for S2. After adjustment for all group-specific diseases, genetic variants in CDKN2B-AS1, NOA1-REST, ERG, ZNF335-MMP9 and SMAD3 were associated with S1 and variants in MMP12, DAB2IP, LHFPL2, LPA, FSTL5 and SORT1 were associated with S2 (all FDR p < 0.05). After adjustment for disease comorbidities and genetic variants differently associated with S1 and S2, the increased risk for all-cause death of S1 than S2 and the difference in AAA expansion rate in subgroups attenuated (Both p-values > 0.09) Conclusions: We identified two subtypes of AAA with different rates of aneurysm expansion and all-cause mortality, which were associated with subtype-specific disease comorbidities and genetic markers, suggesting the potential of leveraging EHR to facilitate individualized medicine in patients with AAA.

Current evidence and prospects for medical treatment of abdominal aortic aneurysms

VASA ◽  
2005 ◽  
Vol 34 (4) ◽  
pp. 217-223 ◽  
Author(s):  
Diehm ◽  
Schmidli ◽  
Dai-Do ◽  
Baumgartner
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Medical Treatment ◽  
Endovascular Treatment ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Current Evidence ◽  
Significant Morbidity ◽  
Abdominal Aortic ◽  
Risk Of Rupture

Abdominal aortic aneurysm (AAA) is a potentially fatal condition with risk of rupture increasing as maximum AAA diameter increases. It is agreed upon that open surgical or endovascular treatment is indicated if maximum AAA diameter exceeds 5 to 5.5cm. Continuing aneurysmal degeneration of aortoiliac arteries accounts for significant morbidity, especially in patients undergoing endovascular AAA repair. Purpose of this review is to give an overview of the current evidence of medical treatment of AAA and describe prospects of potential pharmacological approaches towards prevention of aneurysmal degeneration of small AAAs and to highlight possible adjunctive medical treatment approaches after open surgical or endovascular AAA therapy.

Gender differences in abdominal aortic aneurysm therapy – a systematic review

VASA ◽  
2018 ◽  
Vol 47 (4) ◽  
pp. 267-272 ◽  
Author(s):  
Konstanze Stoberock ◽  
Tilo Kölbel ◽  
Gülsen Atlihan ◽  
Eike Sebastian Debus ◽  
Nikolaos Tsilimparis ◽  
...  
Keyword(s):  
Gender Differences ◽  
Abdominal Aortic Aneurysm ◽  
Survival Rate ◽  
Aortic Aneurysm ◽  
Endovascular Treatment ◽  
Aortic Aneurysms ◽  
Lower Survival Rate ◽  
Lower Survival ◽  
Abdominal Aortic ◽  
Risk Of Rupture

Abstract. This article analyses if and to what extent gender differences exist in abdominal aortic aneurysm (AAA) therapy. For this purpose Medline (PubMed) was searched from January 1999 to January 2018. Keywords were: “abdominal aortic aneurysm”, “gender”, “prevalence”, “EVAR”, and “open surgery of abdominal aortic aneurysm”. Regardless of open or endovascular treatment of abdominal aortic aneurysms, women have a higher rate of complications and longer hospitalizations compared to men. The majority of studies showed that women have a lower survival rate for surgical and endovascular treatment of abdominal aneurysms after both elective and emergency interventions. Women receive less surgical/interventional and protective medical treatment. Women seem to have a higher risk of rupture, a lower survival rate in AAA, and a higher rate of complications, regardless of endovascular or open treatment. The gender differences may be due to a higher age of women at diagnosis and therapy associated with higher comorbidity, but also because of genetic, hormonal, anatomical, biological, and socio-cultural differences. Strategies for treatment in female patients must be further defined to optimize outcome.

scholarly journals Correction to: Isolated ascending aorta dilatation is associated with increased risk of abdominal aortic aneurysm

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Enrique Gallego-Colon ◽  
Chaim Yosefy ◽  
Evgenia Cherniavsky ◽  
Azriel Osherov ◽  
Vladimir Khalameizer ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Ascending Aorta ◽  
Abdominal Aortic ◽  
Increased Risk ◽  
Aorta Dilatation

scholarly journals Comparison of open versus endovascular surgical treatment of abdominal aortic aneurysm

2020 ◽  
Vol 6 (3) ◽  
pp. 477-480
Author(s):  
Sabine Kischkel ◽  
Carsten M. Bünger
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Treatment Options ◽  
Prosthetic Graft ◽  
Healthcare Research ◽  
Vascular Medicine ◽  
Related Complication ◽  
Abdominal Aortic ◽  
Open Aortic Repair ◽  
Risk Of Rupture

AbstractAbdominal aortic aneurysm (AAA) is a common condition of increasing prevalence, particularly among older men. An AAA is defined as a permanent dilation of the abdominal aorta, with a diameter greater than 30 mm or a diameter greater than 50% of the aortic diameter at the level of the diaphragm. As the size of the aneurysm increases, so does the risk of rupture. Therefore, prophylactic repair with insertion of a prosthetic graft is offered. Since 1951 traditional open aneurysm repair (OAR) was reported and minimally invasive endovascular repair (EVAR) was first reported in 1986. Data from four randomized controlled trials (EVAR-1, DREAM, OVER, ACE) for abdominal aortic aneurysm, which enrolled almost 3000 patients, in a period from 1999 to 2008, were summarized. In addition, registry databases on the treatment of AAA of average 4000 patients per year, based from 2015 to 2018 of the German Institute for Vascular Medicine Healthcare Research of the German Society for Vascular Surgery and Vascular Medicine, were compared. The EVAR procedure for AAA showed a lower risk of perioperative mortality but was associated with a higher cardiovascular and aneurysm-related complication rate. In particular, patients aged 80 years or older benefited from EVAR since the 30-day mortality of patients receiving OAR was higher. In mid-term and long-term follow-up there were no differences in survival after endovascular and open aortic repair. Overall, it depends on the respective underlying disease and anatomy which of the two approaches is to be preferred. In conclusion, both treatment options can be considered as equal and can be offered to patients.

scholarly journals Isolated ascending aorta dilatation is associated with increased risk of abdominal aortic aneurysm

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Enrique Gallego-Colon ◽  
Chaim Yosefy ◽  
Evgenia Cherniavsky ◽  
Azriel Osherov ◽  
Vladimir Khalameizer ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Multiple Logistic Regression Analysis ◽  
Ascending Aorta ◽  
Predictive Tool ◽  
Computed Tomographic ◽  
Hemodynamic Compromise ◽  
Abdominal Aortic ◽  
Imaging Results ◽  
Increased Risk

Abstract Background Abdominal aortic aneurysm (AAA) is an asymptomatic condition characterized by progressive dilatation of the aorta. The purpose of this study is to identify important 2D-TTE aortic indices associated with AAA as predictive tools for undiagnosed AAA. Methods In this retrospective study, we evaluated the size of the ascending aorta in patients without known valvular diseases or hemodynamic compromise as predictive tool for undiagnosed AAA. We studied the tubular ascending aorta of 170 patients by 2-dimensional transthoracic echocardiography (2D-TTE). Patients were further divided into two groups, 70 patients with AAA and 100 patients without AAA with normal imaging results. Results Dilatation of tubular ascending aorta was measured in patients with AAA compared to the group with absent AAA (37.5 ± 4.8 mm vs. 31.2 ± 3.6 mm, p < 0.001, respectively) and confirmed by computed tomographic (CT) (35.6 ± 5.1 mm vs. 30.8 ± 3.7 mm, p < 0.001, respectively). An increase in tubular ascending aorta size was associated with the presence of AAA by both 2D-TTE and CT (r = 0.40, p < 0.001 and r = 0.37, p < 0.001, respectively). The tubular ascending aorta (D diameter) size of ≥33 mm or ≥ 19 mm/m2 presented with 2–4 times more risk of AAA presence (OR 4.68, CI 2.18–10.25, p = 0.001 or OR 2.63, CI 1.21–5.62, p = 0.02, respectively). In addition, multiple logistic regression analysis identified tubular ascending aorta (OR 1.46, p < 0.001), age (OR 1.09, p = 0.013), gender (OR 0.12, p = 0.002), and LVESD (OR 1.24, p = 0.009) as independent risk factors of AAA presence. Conclusions An increased tubular ascending aortic diameter, measured by 2D-TTE, is associated with the presence of AAA. Routine 2D-TTE screening for silent AAA by means of ascending aorta analysis, may appear useful especially in older patients with a dilated tubular ascending aorta (≥33 mm).

scholarly journals Swedish snuff (snus) and risk of cardiovascular disease and mortality: prospective cohort study of middle-aged and older individuals

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Olga E. Titova ◽  
John A. Baron ◽  
Karl Michaëlsson ◽  
Susanna C. Larsson
Keyword(s):  
Cardiovascular Disease ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Older Individuals ◽  
Middle Aged ◽  
Entire Study ◽  
Abdominal Aortic ◽  
Increased Risk ◽  
Never Smokers ◽  
Cvd Mortality

Abstract Background Cigarette smoking is a well-known risk factor for cardiovascular disease (CVD), but whether smokeless tobacco such as snuff is associated with the risk of CVD is still unclear. We investigated the association of the use of Swedish oral moist snuff (snus) with a broad range of CVDs and CVD mortality. Methods We used data from a population-based cohort of 41,162 Swedish adults with a mean baseline age of 70 (56–94) years who completed questionnaires regarding snus use and other lifestyle habits and health characteristics. Participants were followed up for incident cardiovascular outcomes and death over 8 years through linkage to the Swedish National Patient and Death Registers. Hazard ratios (HR) were estimated by Cox proportional hazards regression. We conducted analyses among all subjects as well as among never smokers to reduce residual confounding from smoking. Results After adjustment for smoking and other confounders, snus use was not associated with myocardial infarction, heart failure, atrial fibrillation, aortic valve stenosis, abdominal aortic aneurysm, stroke, or CVD mortality. However, in never smokers, snus use was associated with a statistically significant increased risk of total and ischemic stroke (HRs [95% confidence intervals] = 1.52 [1.01–2.30] and 1.63 [1.05–2.54], respectively) and non-significantly positively associated with some other CVDs. Conclusions In this middle-aged and elderly Swedish population, current Swedish snus use was not associated with the risk of major heart and valvular diseases, abdominal aortic aneurysm, or CVD mortality in the entire study population, but was linked to an increased risk of stroke in never smokers.

Challenges of applying circulating biomarkers for abdominal aortic aneurysm progression

2021 ◽  
pp. 153537022199253
Author(s):  
Yuan Li ◽  
Dan Yang ◽  
Yuehong Zheng
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Prognostic Models ◽  
Rapid Progression ◽  
Circulating Biomarkers ◽  
Invasive Treatment ◽  
Abdominal Symptoms ◽  
Abdominal Aortic ◽  
Risk Of Rupture ◽  
Threatening Condition

As a prevalent potentially life-threatening condition, abdominal aortic aneurysm (AAA) presents increasing risk of rupture as its diameter grows. However, rapid progression and rupture may occasionally occur in smaller AAAs. Earlier surgery for patients with high risk of disease progression may improve the outcome. Therefore, more precise indicators for invasive treatment in addition to diameter and abdominal symptoms are demanded. This systematic review aimed to identify potential circulating biomarkers that may predict growth rate of AAA. Cochrane and PubMed library were searched (until August 2020) for researches which reported circulating biomarkers associated with AAA expansion, and 25 papers were included. Twenty-eight identified biomarkers were further classified into five categories (inflammation and oxidative stress, matrix degradation, hematology and lipid metabolism, thrombosis and fibrinolysis, and others), and discussed further with their correlation and regression analysis results. Larger prospective trials are required to establish and evaluate prognostic models with highest values with these markers.

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