Thoracic Aortic Aneurysm Growth: Role of Sex and Aneurysm Etiology

Background Thoracic aortic aneurysm (TAA) outcomes are worse in women than men, although reasons for sex differences are unknown. Because faster TAA growth is a risk factor for acute aortic syndromes, we sought to determine the role of sex and aneurysm etiology on TAA growth. Methods and Results Eig...

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Vydáno v:Journal of the American Heart Association Ročník 6; číslo 2
Hlavní autoři: Cheung, Katie, Boodhwani, Munir, Chan, Kwan‐Leung, Beauchesne, Luc, Dick, Alexander, Coutinho, Thais
Médium: Journal Article
Jazyk:angličtina
Vydáno: England John Wiley and Sons Inc 03.02.2017
Wiley
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ISSN:2047-9980, 2047-9980
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Abstract Background Thoracic aortic aneurysm (TAA) outcomes are worse in women than men, although reasons for sex differences are unknown. Because faster TAA growth is a risk factor for acute aortic syndromes, we sought to determine the role of sex and aneurysm etiology on TAA growth. Methods and Results Eighty‐two consecutive unoperated subjects with TAA who had serial aneurysm measurements were recruited. In multivariable linear regression the association of female sex with aneurysm growth rate was assessed after adjustment for potential confounders. We also tested the interaction term sex×aneurysm etiology in the prediction of TAA growth. Seventy‐four percent of subjects were men; mean±SD age was 62.4±11.9 years in men and 67.7±10.7 years in women (P=0.06). Forty‐seven (57%) subjects had degenerative TAAs, and the remainder had heritable TAAs. Absolute baseline aneurysm size and follow‐up time were not different between men and women. Aneurysm growth rate was 1.19±1.15 mm/y in women and 0.59±0.66 mm/y in men (P=0.02). Female sex remained significantly associated with greater aneurysm growth in multivariable analyses (β±SE: 0.35±0.12, P=0.005). In addition, female sex was associated with faster TAA growth only among those with degenerative TAA (β±SE: 0.33±0.08, P=0.0002) and not among those with heritable TAA (P=0.79), with a significant sex×etiology interaction (P=0.001). Conclusions TAA growth rates are greater in women than men, and this difference is specific to women with degenerative TAAs. Our findings may explain sex differences in TAA outcomes and provide a foundation for future investigations of this topic.
AbstractList Background Thoracic aortic aneurysm (TAA) outcomes are worse in women than men, although reasons for sex differences are unknown. Because faster TAA growth is a risk factor for acute aortic syndromes, we sought to determine the role of sex and aneurysm etiology on TAA growth. Methods and Results Eighty‐two consecutive unoperated subjects with TAA who had serial aneurysm measurements were recruited. In multivariable linear regression the association of female sex with aneurysm growth rate was assessed after adjustment for potential confounders. We also tested the interaction term sex×aneurysm etiology in the prediction of TAA growth. Seventy‐four percent of subjects were men; mean±SD age was 62.4±11.9 years in men and 67.7±10.7 years in women (P=0.06). Forty‐seven (57%) subjects had degenerative TAAs, and the remainder had heritable TAAs. Absolute baseline aneurysm size and follow‐up time were not different between men and women. Aneurysm growth rate was 1.19±1.15 mm/y in women and 0.59±0.66 mm/y in men (P=0.02). Female sex remained significantly associated with greater aneurysm growth in multivariable analyses (β±SE: 0.35±0.12, P=0.005). In addition, female sex was associated with faster TAA growth only among those with degenerative TAA (β±SE: 0.33±0.08, P=0.0002) and not among those with heritable TAA (P=0.79), with a significant sex×etiology interaction (P=0.001). Conclusions TAA growth rates are greater in women than men, and this difference is specific to women with degenerative TAAs. Our findings may explain sex differences in TAA outcomes and provide a foundation for future investigations of this topic.
BackgroundThoracic aortic aneurysm (TAA) outcomes are worse in women than men, although reasons for sex differences are unknown. Because faster TAA growth is a risk factor for acute aortic syndromes, we sought to determine the role of sex and aneurysm etiology on TAA growth. Methods and ResultsEighty‐two consecutive unoperated subjects with TAA who had serial aneurysm measurements were recruited. In multivariable linear regression the association of female sex with aneurysm growth rate was assessed after adjustment for potential confounders. We also tested the interaction term sex×aneurysm etiology in the prediction of TAA growth. Seventy‐four percent of subjects were men; mean±SD age was 62.4±11.9 years in men and 67.7±10.7 years in women (P=0.06). Forty‐seven (57%) subjects had degenerative TAAs, and the remainder had heritable TAAs. Absolute baseline aneurysm size and follow‐up time were not different between men and women. Aneurysm growth rate was 1.19±1.15 mm/y in women and 0.59±0.66 mm/y in men (P=0.02). Female sex remained significantly associated with greater aneurysm growth in multivariable analyses (β±SE: 0.35±0.12, P=0.005). In addition, female sex was associated with faster TAA growth only among those with degenerative TAA (β±SE: 0.33±0.08, P=0.0002) and not among those with heritable TAA (P=0.79), with a significant sex×etiology interaction (P=0.001). ConclusionsTAA growth rates are greater in women than men, and this difference is specific to women with degenerative TAAs. Our findings may explain sex differences in TAA outcomes and provide a foundation for future investigations of this topic.
Thoracic aortic aneurysm (TAA) outcomes are worse in women than men, although reasons for sex differences are unknown. Because faster TAA growth is a risk factor for acute aortic syndromes, we sought to determine the role of sex and aneurysm etiology on TAA growth.BACKGROUNDThoracic aortic aneurysm (TAA) outcomes are worse in women than men, although reasons for sex differences are unknown. Because faster TAA growth is a risk factor for acute aortic syndromes, we sought to determine the role of sex and aneurysm etiology on TAA growth.Eighty-two consecutive unoperated subjects with TAA who had serial aneurysm measurements were recruited. In multivariable linear regression the association of female sex with aneurysm growth rate was assessed after adjustment for potential confounders. We also tested the interaction term sex×aneurysm etiology in the prediction of TAA growth. Seventy-four percent of subjects were men; mean±SD age was 62.4±11.9 years in men and 67.7±10.7 years in women (P=0.06). Forty-seven (57%) subjects had degenerative TAAs, and the remainder had heritable TAAs. Absolute baseline aneurysm size and follow-up time were not different between men and women. Aneurysm growth rate was 1.19±1.15 mm/y in women and 0.59±0.66 mm/y in men (P=0.02). Female sex remained significantly associated with greater aneurysm growth in multivariable analyses (β±SE: 0.35±0.12, P=0.005). In addition, female sex was associated with faster TAA growth only among those with degenerative TAA (β±SE: 0.33±0.08, P=0.0002) and not among those with heritable TAA (P=0.79), with a significant sex×etiology interaction (P=0.001).METHODS AND RESULTSEighty-two consecutive unoperated subjects with TAA who had serial aneurysm measurements were recruited. In multivariable linear regression the association of female sex with aneurysm growth rate was assessed after adjustment for potential confounders. We also tested the interaction term sex×aneurysm etiology in the prediction of TAA growth. Seventy-four percent of subjects were men; mean±SD age was 62.4±11.9 years in men and 67.7±10.7 years in women (P=0.06). Forty-seven (57%) subjects had degenerative TAAs, and the remainder had heritable TAAs. Absolute baseline aneurysm size and follow-up time were not different between men and women. Aneurysm growth rate was 1.19±1.15 mm/y in women and 0.59±0.66 mm/y in men (P=0.02). Female sex remained significantly associated with greater aneurysm growth in multivariable analyses (β±SE: 0.35±0.12, P=0.005). In addition, female sex was associated with faster TAA growth only among those with degenerative TAA (β±SE: 0.33±0.08, P=0.0002) and not among those with heritable TAA (P=0.79), with a significant sex×etiology interaction (P=0.001).TAA growth rates are greater in women than men, and this difference is specific to women with degenerative TAAs. Our findings may explain sex differences in TAA outcomes and provide a foundation for future investigations of this topic.CONCLUSIONSTAA growth rates are greater in women than men, and this difference is specific to women with degenerative TAAs. Our findings may explain sex differences in TAA outcomes and provide a foundation for future investigations of this topic.
Thoracic aortic aneurysm (TAA) outcomes are worse in women than men, although reasons for sex differences are unknown. Because faster TAA growth is a risk factor for acute aortic syndromes, we sought to determine the role of sex and aneurysm etiology on TAA growth. Eighty-two consecutive unoperated subjects with TAA who had serial aneurysm measurements were recruited. In multivariable linear regression the association of female sex with aneurysm growth rate was assessed after adjustment for potential confounders. We also tested the interaction term sex×aneurysm etiology in the prediction of TAA growth. Seventy-four percent of subjects were men; mean±SD age was 62.4±11.9 years in men and 67.7±10.7 years in women (P=0.06). Forty-seven (57%) subjects had degenerative TAAs, and the remainder had heritable TAAs. Absolute baseline aneurysm size and follow-up time were not different between men and women. Aneurysm growth rate was 1.19±1.15 mm/y in women and 0.59±0.66 mm/y in men (P=0.02). Female sex remained significantly associated with greater aneurysm growth in multivariable analyses (β±SE: 0.35±0.12, P=0.005). In addition, female sex was associated with faster TAA growth only among those with degenerative TAA (β±SE: 0.33±0.08, P=0.0002) and not among those with heritable TAA (P=0.79), with a significant sex×etiology interaction (P=0.001). TAA growth rates are greater in women than men, and this difference is specific to women with degenerative TAAs. Our findings may explain sex differences in TAA outcomes and provide a foundation for future investigations of this topic.
Author Boodhwani, Munir
Dick, Alexander
Chan, Kwan‐Leung
Cheung, Katie
Beauchesne, Luc
Coutinho, Thais
AuthorAffiliation 3 Division of Cardiology University of Ottawa Heart Institute Ottawa Ontario Canada
2 Division of Cardiac Surgery University of Ottawa Heart Institute Ottawa Ontario Canada
1 School of Biomedical Sciences University of Ottawa Ontario Canada
AuthorAffiliation_xml – name: 1 School of Biomedical Sciences University of Ottawa Ontario Canada
– name: 2 Division of Cardiac Surgery University of Ottawa Heart Institute Ottawa Ontario Canada
– name: 3 Division of Cardiology University of Ottawa Heart Institute Ottawa Ontario Canada
Author_xml – sequence: 1
  givenname: Katie
  surname: Cheung
  fullname: Cheung, Katie
  organization: University of Ottawa
– sequence: 2
  givenname: Munir
  surname: Boodhwani
  fullname: Boodhwani, Munir
  organization: University of Ottawa Heart Institute
– sequence: 3
  givenname: Kwan‐Leung
  surname: Chan
  fullname: Chan, Kwan‐Leung
  organization: University of Ottawa Heart Institute
– sequence: 4
  givenname: Luc
  surname: Beauchesne
  fullname: Beauchesne, Luc
  organization: University of Ottawa Heart Institute
– sequence: 5
  givenname: Alexander
  surname: Dick
  fullname: Dick, Alexander
  organization: University of Ottawa Heart Institute
– sequence: 6
  givenname: Thais
  surname: Coutinho
  fullname: Coutinho, Thais
  email: tcoutinho@ottawaheart.ca
  organization: University of Ottawa Heart Institute
BackLink https://www.ncbi.nlm.nih.gov/pubmed/28159818$$D View this record in MEDLINE/PubMed
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Keywords aneurysm
aorta
thoracic aortic aneurysm
hypertension
women
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24583920 - J Mech Behav Biomed Mater. 2014 Jun;34:154-64
9580243 - J Vasc Surg. 1998 Mar;27(3):446-53
23122799 - J Am Coll Cardiol. 2013 Jan 8;61(1):96-103
17262754 - Br J Surg. 2007 Mar;94(3):310-4
12440685 - Ann Thorac Surg. 2002 Nov;74(5):S1877-80; discussion S1892-8
15197151 - Circulation. 2004 Jun 22;109(24):3014-21
24882528 - Can J Cardiol. 2014 Jun;30(6):577-89
3510513 - AJR Am J Roentgenol. 1986 Feb;146(2):309-14
9205145 - Ann Thorac Surg. 1997 Jun;63(6):1533-45
22622125 - G Ital Cardiol (Rome). 2012 Jun;13(6):448-60
24972124 - J Neurosurg. 2014 Sep;121(3):599-604
22389113 - Br J Surg. 2012 May;99(5):655-65
25520374 - Circulation. 2015 Jan 27;131(4):e29-322
25623219 - J Am Soc Echocardiogr. 2015 Feb;28(2):119-82
20013940 - Br J Surg. 2010 Jan;97(1):37-44
22041041 - Semin Thorac Cardiovasc Surg. 2011 Summer;23(2):124-5
20061425 - J Clin Endocrinol Metab. 2010 Mar;95(3):1123-30
11834007 - Ann Thorac Surg. 2002 Jan;73(1):17-27; discussion 27-8
15557917 - J Vasc Surg. 2004 Nov;40(5):1001-10
21641282 - Lancet Neurol. 2011 Jul;10(7):626-36
22503227 - J Vasc Surg. 2012 Aug;56(2):311-6
25609416 - J Am Heart Assoc. 2015 Jan 21;4(1):e001513
5527019 - Cancer Chemother Rep. 1970 Aug;54(4):225-35
15561045 - Ann Thorac Surg. 2004 Dec;78(6):2106-10; discussion 2110-1
22840907 - J Vasc Surg. 2012 Aug;56(2):565-71
24067626 - Health Technol Assess. 2013 Sep;17(41):1-118
15649720 - Eur J Vasc Endovasc Surg. 2005 Feb;29(2):145-9
17383337 - Ann Thorac Surg. 2007 Apr;83(4):1338-44
11861412 - Circ Res. 2002 Feb 22;90(3):251-62
16368358 - Ann Thorac Surg. 2006 Jan;81(1):169-77
9081092 - J Thorac Cardiovasc Surg. 1997 Mar;113(3):476-91; discussion 489-91
20233780 - Circulation. 2010 Apr 6;121(13):e266-369
17709637 - Circulation. 2007 Sep 4;116(10):1120-7
23813847 - Heart. 2014 Feb;100(4):295-302
10807810 - Chest. 2000 May;117(5):1271-8
17145990 - Circulation. 2006 Dec 12;114(24):2611-8
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Snippet Background Thoracic aortic aneurysm (TAA) outcomes are worse in women than men, although reasons for sex differences are unknown. Because faster TAA growth is...
Thoracic aortic aneurysm (TAA) outcomes are worse in women than men, although reasons for sex differences are unknown. Because faster TAA growth is a risk...
BackgroundThoracic aortic aneurysm (TAA) outcomes are worse in women than men, although reasons for sex differences are unknown. Because faster TAA growth is a...
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Index Database
Enrichment Source
Publisher
SubjectTerms Aged
aneurysm
aorta
Aortic Aneurysm, Thoracic - diagnosis
Aortic Aneurysm, Thoracic - epidemiology
Aortic Aneurysm, Thoracic - etiology
Disease Progression
Echocardiography
Female
Humans
hypertension
Incidence
Magnetic Resonance Imaging
Male
Middle Aged
Ontario - epidemiology
Original Research
Prognosis
Retrospective Studies
Risk Assessment - methods
Risk Factors
Sex Factors
thoracic aortic aneurysm
Tomography, X-Ray Computed
women
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Title Thoracic Aortic Aneurysm Growth: Role of Sex and Aneurysm Etiology
URI https://onlinelibrary.wiley.com/doi/abs/10.1161%2FJAHA.116.003792
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