Thrombus volume is associated with cardiovascular events and aneurysm growth in patients who have abdominal aortic aneurysms.
Thrombus volume is associated with cardiovascular events and aneurysm growth in patients who have abdominal aortic aneurysms.
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DOI：
10.1016/j.jvs.2010.08.013
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发表时间：
2011-01
影响因子：
4.3
通讯作者：
Golledge, Jonathan
中科院分区：
文献类型：
--
作者：
Parr, Adam;McCann, Moira;Bradshaw, Barbara;Shahzad, Anwar;Buttner, Petra;Golledge, Jonathan
腹主动脉瘤（AAA）患者易发生心血管事件，且常经历动脉瘤持续扩张。心血管事件和扩张率与动脉瘤大小呈正相关。AAA通常与腔内血栓相关，这与AAA的发病机制有关。本研究的目的是前瞻性评估肾下腹主动脉血栓体积与心血管事件和AAA生长的关系。98例AAAs患者行计算机断层血管造影（CTA）。肾主动脉下血栓的体积是通过先前验证的技术来测量的。对患者进行前瞻性随访，中位数为3年（四分位数间隔2.0-3.6年），并记录心血管事件（非致死性卒中、非致死性心肌梗死、冠状动脉血运重建术、截肢和心血管死亡）。39例原始患者在进入研究后中位数为1.5年（四分位数间距，1.1-3.3年）接受了重复CTA。Kaplan-Meier和cox -比例分析用于检查主动脉血栓与心血管事件和平均加权AAA生长的关系。随访期间共发生28例心血管事件。4年时，主动脉血栓体积小（<中位数）和体积大（≥中位数）患者的心血管事件发生率分别为23.4和49.2% （p=0.040）。AAA血栓体积≥中位数与心血管事件增加相关（RR 2.8, 95% CI 1.01 - 5.24），独立于包括初始AAA直径在内的其他危险因素，但只有当患者在AAA修复时被检查时才具有临界意义（RR 2.35, 95% CI 0.98-5.63）。在CTA随访的患者亚组中，AAA容量的年中位数增加为5.1cm3（四分位数间距为0.8-10.3）。年AAA容积增加与初始AAA直径（r=0.44, p=0.006）和血栓体积（r=0.50, p=0.001）呈正相关。主动脉血栓体积≥中位数与AAA容量快速增加（≥5cm/年）相关，与初始主动脉直径无关（OR 15.0, 95% CI 1.9-115.7, p=0.009）。在这个小队列中，肾下主动脉血栓体积与心血管事件发生率和AAA进展相关。这些结果需要在进一步的大型研究中得到证实，并阐明这些关联的潜在机制。
Patients with abdominal aortic aneurysms (AAA) are predisposed to cardiovascular events and often experience continual expansion of their aneurysm. Cardiovascular events and expansion rates are positively correlated with aneurysm size. AAA is usually associated with intraluminal thrombus, which has previously been implicated in AAA pathogenesis. The aims of this study were to prospectively assess the association of infra-renal abdominal aortic thrombus volume with cardiovascular events and AAA growth. 98 patients with AAAs underwent computed tomography angiography (CTA). The volume of infra-renal aorta thrombus was measured by a previously validated technique. Patients were followed prospectively for a median of 3 (inter-quartile range 2.0–3.6) years and cardiovascular events (non-fatal stroke, non-fatal myocardial infarction, coronary revascularization, amputation and cardiovascular death) recorded. 39 of the original patients underwent repeat CTA a median of 1.5 (inter-quartile range, 1.1–3.3) years after entry to the study. Kaplan-Meier and Cox-proportional analysis were used to examine the association of aortic thrombus with cardiovascular events and average weighted AAA growth. A total of 28 cardiovascular event occurred during follow-up. The incidence of cardiovascular events was 23.4 and 49.2% for patients with small (<median) and large (≥median) volumes of aortic thrombus, respectively, at 4 years (p=0.040). AAA thrombus volume ≥median was associated with increased cardiovascular events (RR 2.8, 95% CI 1.01– 5.24) independent of other risk factors including initial AAA diameter, but only of borderline significance when patients were censored at the time of AAA repair (RR 2.35, 95% CI 0.98–5.63). In the sub-set of patients with CTA follow-up median annual increase in AAA volume was 5.1cm3 (inter-quartile range 0.8–10.3). Annual AAA volume increase was positively correlated with initial AAA diameter (r=0.44, p=0.006) and thrombus volume (r=0.50, p=0.001). Aortic thrombus volume ≥median was associated with rapid AAA volume increase (≥5cm/year), independent of initial aortic diameter (OR 15.0, 95% CI 1.9–115.7, p=0.009). In this small cohort infra-renal aortic thrombus volume was associated with the incidence of cardiovascular events and AAA progression. These results need to be confirmed and mechanisms underlying the associations clarified in large further studies.
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DOI：
10.1016/j.ejvs.2005.10.007
发表时间：
2006-03-01
影响因子：
5.7
作者：
de Céniga, MV;Gómez, R;Barba, A
通讯作者：
Barba, A
影响因子：
3
作者：
GUIRGUIS, EM;BARBER, GG
通讯作者：
BARBER, GG
影响因子：
1.5
作者：
Koskas, F;Kieffer, E
通讯作者：
Kieffer, E
影响因子：
158.5
作者：
Lederle, FA;Wilson, SE;Bandyk, D
通讯作者：
Bandyk, D
DOI：
10.1016/s1078-5884(98)80150-0
发表时间：
1998-08-01
影响因子：
5.7
作者：
Galland, RB;Whiteley, MS;Magee, TR
通讯作者：
Magee, TR