Asthma Associates With Human Abdominal Aortic Aneurysm and Rupture.
Asthma Associates With Human Abdominal Aortic Aneurysm and Rupture.
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哮喘与人类腹主动脉瘤和破裂有关
DOI：
10.1161/atvbaha.115.306497
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发表时间：
2016-03
期刊：
影响因子：
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通讯作者：
Shi GP
中科院分区：
文献类型：
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作者：
Liu CL;Wemmelund H;Wang Y;Liao M;Lindholt JS;Johnsen SP;Vestergaard H;Fernandes C;Sukhova GK;Cheng X;Zhang JY;Yang C;Huang X;Daugherty A;Levy BD;Libby P;Shi GP
哮喘和腹主动脉瘤（AAA）都涉及炎症。目前尚不清楚这些疾病是否相互作用。分析的数据库包括DNRP：一项基于人群的全国性病例对照研究纳入了1996-2012年间丹麦所有破裂AAA（rAAA）患者以及年龄和性别匹配的未破裂AAA对照。VIVA：基于人群的随机维堡血管筛查试验受试者的亚组研究。哮喘患者根据医院诊断、支气管扩张剂使用和记录的其他抗哮喘处方药使用情况进行分类。拟合逻辑回归模型以确定哮喘是否与DNRP中rAAA的风险相关，以及VIVA试验中筛选时AAA的独立风险。根据DNRP研究，在索引日期前不到1年或6个月诊断的哮喘增加了AAA合并症调整前（比值比OR=1.60，2.12）和调整后（OR=1.51，2.06）AAA破裂的风险。使用支气管扩张剂增加了AAA破裂的风险，从曾经使用到索引日期后90天内，调整前（OR=1.10~1.37）和调整后（OR=1.10~1.31）。使用抗哮喘药物的患者在调整前（OR=1.12~1.79）和调整后（OR=1.09~1.48）也显示破裂风险增加。在VIVA中，使用抗哮喘药物与调整吸烟（OR = 1.45）或其他风险因素（OR =1.46）之前（OR=1.45）或之后AAA风险增加相关。近期活动性哮喘增加AAA和AAA破裂的风险。这些发现记录并提供了气道疾病和AAA（两种具有相同炎症方面的常见疾病）之间的新联系。
Asthma and abdominal aortic aneurysms (AAA) both involve inflammation. It remains unknown whether these diseases interact. Databases analyzed included DNRP: a population-based nationwide case-control study included all patients with ruptured AAA (rAAA) and age- and sex-matched AAA controls without rupture in Denmark from 1996–2012. VIVA: Subgroup study of participants from the population-based randomized Viborg vascular screening trial. Asthmatic patients were categorized by hospital diagnosis, bronchodilator use, and the recorded use of other anti-asthma prescription medications. Logistic regression models were fitted to determine whether asthma associated with the risk of rAAA in DNRP, and an independent risk of having an AAA at screening in the VIVA trial. From the DNRP study, asthma diagnosed less than one year or six months before the index date increased the risk of AAA rupture before (odds ratio OR=1.60, 2.12) and after (OR=1.51, 2.06) adjusting for AAA comorbidities. Use of bronchodilators elevated the risk of AAA rupture from ever use to within 90 days from the index date, before (OR=1.10~1.37) and after (OR=1.10~1.31) adjustment. Patients prescribed anti-asthma drugs also showed an increased risk of rupture before (OR=1.12~1.79) and after (OR=1.09~1.48) the same adjustment. In VIVA, anti-asthmatic medication use associated with increased risk of AAA before (OR=1.45) or after adjustment for smoking (OR=1.45) or other risk factors (OR=1.46). Recent active asthma increased risk of AAA and AAA-rupture. These findings document and furnish novel links between airway disease and AAA, two common diseases that share inflammatory aspects.