Ascending Thoracic Aortic Aneurysms Protect Against Myocardial Infarctions
Ascending Thoracic Aortic Aneurysms Protect Against Myocardial Infarctions
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DOI：
10.1055/s-0034-1382288
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发表时间：
2014-09-01
影响因子：
0.6
通讯作者：
Elefteriades, John A.
中科院分区：
文献类型：
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作者：
Chau, Katherine;Elefteriades, John A.
越来越多的证据表明，胸升主动脉瘤（TAAs）可以预防动脉粥样硬化。然而，还没有研究探讨动脉粥样硬化的临床终点，如中风或外周动脉疾病之间的关系。在本研究中，我们的目标是描述TAA与动脉粥样硬化、心肌梗死（MI）的特定临床终点之间的关系。我们比较了487例因上行型TAA接受手术修复的患者与500例无上行型TAA的对照患者的冠状动脉疾病（CAD）和MI的患病率。采用多变量二元逻辑回归分析，计算患者TAA升高与任何一种MI风险因素相比发生MI的几率。与对照组相比，上行TAA组的CAD和MI患病率显著降低。如果患者有MI风险因素，则发生MI的几率均> 1（更可能发生MI），统计学显著性最低的比值比为1.54（年龄; p = 0.001），最高的比值比为14.9（MI家族史; p < 0.001）。然而，如果患者TAA升高，则MI的比值比接近0，为0.05（p < 0.001）。这项研究提供了证据表明，上行TAA保护免受MI，进一步支持上行TAA保护免受动脉粥样硬化疾病的假设。
There has been increasing evidence that ascending thoracic aortic aneurysms (TAAs) protect against atherosclerosis. However, there have been no studies examining the relationship between ascending TAAs and clinical endpoints of atherosclerosis, such as stroke or peripheral arterial disease. In this study, we aim to characterize the relationship between TAAs and a specific clinical endpoint of atherosclerosis, myocardial infarction (MI). We compared prevalence of coronary artery disease (CAD) and MIs in 487 patients who underwent surgical repair for ascending TAAs to 500 control patients who did not have an ascending TAA. Multivariate binary logistic regression was used to calculate the odds of having MI if a patient had an ascending TAA versus any of several MI risk factors. There was a significantly lower prevalence of CAD and MI in the ascending TAA group than in the control TAA group. The odds of having a MI if a patient had a MI risk factor were all > 1 (more likely to have a MI), with the lowest statistically significant odds ratio being 1.54 (age; p = 0.001) and the highest being 14.9 (family history of MI; p < 0.001). The odds ratio of having a MI if a patient had an ascending TAA, however, was near 0 at 0.05 (p < 0.001). This study provides evidence that ascending TAAs protect against MIs, adding further support to the hypothesis that ascending TAAs protect against atherosclerotic disease.