Ascending Thoracic Aortic Aneurysms Protect Against Myocardial Infarctions

Overview

Journal Int J Angiol

Date 2014 Oct 16

PMID 25317029

Citations 9

Authors

Katherine Chau

John A Elefteriades

Affiliations

Soon will be listed here.

Abstract

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.

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References

Lutgens E, Gijbels M, Smook M, Heeringa P, Gotwals P, Koteliansky V . Transforming growth factor-beta mediates balance between inflammation and fibrosis during plaque progression. Arterioscler Thromb Vasc Biol. 2002; 22(6):975-82. DOI: 10.1161/01.atv.0000019729.39500.2f. View

Grainger D . Transforming growth factor beta and atherosclerosis: so far, so good for the protective cytokine hypothesis. Arterioscler Thromb Vasc Biol. 2003; 24(3):399-404. DOI: 10.1161/01.ATV.0000114567.76772.33. View

Humphries S, Luong L, Talmud P, FRICK M, Kesaniemi Y, Pasternack A . The 5A/6A polymorphism in the promoter of the stromelysin-1 (MMP-3) gene predicts progression of angiographically determined coronary artery disease in men in the LOCAT gemfibrozil study. Lopid Coronary Angiography Trial. Atherosclerosis. 1998; 139(1):49-56. DOI: 10.1016/s0021-9150(98)00053-7. View

Achneck H, Modi B, Shaw C, Rizzo J, Albornoz G, Fusco D . Ascending thoracic aneurysms are associated with decreased systemic atherosclerosis. Chest. 2005; 128(3):1580-6. DOI: 10.1378/chest.128.3.1580. View

Agmon Y, Khandheria B, Meissner I, Schwartz G, Sicks J, Fought A . Is aortic dilatation an atherosclerosis-related process? Clinical, laboratory, and transesophageal echocardiographic correlates of thoracic aortic dimensions in the population with implications for thoracic aortic aneurysm formation. J Am Coll Cardiol. 2003; 42(6):1076-83. DOI: 10.1016/s0735-1097(03)00922-7. View

Neptune E, Frischmeyer P, Arking D, Myers L, Bunton T, Gayraud B . Dysregulation of TGF-beta activation contributes to pathogenesis in Marfan syndrome. Nat Genet. 2003; 33(3):407-11. DOI: 10.1038/ng1116. View

Lemaitre V, OByrne T, Borczuk A, Okada Y, Tall A, DArmiento J . ApoE knockout mice expressing human matrix metalloproteinase-1 in macrophages have less advanced atherosclerosis. J Clin Invest. 2001; 107(10):1227-34. PMC: 209293. DOI: 10.1172/JCI9626. View

Ye S, Eriksson P, Hamsten A, Kurkinen M, Humphries S, Henney A . Progression of coronary atherosclerosis is associated with a common genetic variant of the human stromelysin-1 promoter which results in reduced gene expression. J Biol Chem. 1996; 271(22):13055-60. DOI: 10.1074/jbc.271.22.13055. View

Saitta A, Morabito N, Frisina N, Cucinotte D, Corrado F, DAnna R . Cardiovascular effects of raloxifene hydrochloride. Cardiovasc Drug Rev. 2001; 19(1):57-74. DOI: 10.1111/j.1527-3466.2001.tb00183.x. View

10.

Nataatmadja M, West J, West M . Overexpression of transforming growth factor-beta is associated with increased hyaluronan content and impairment of repair in Marfan syndrome aortic aneurysm. Circulation. 2006; 114(1 Suppl):I371-7. DOI: 10.1161/CIRCULATIONAHA.105.000927. View

11.

Kaschina E, Scholz H, Steckelings U, Sommerfeld M, Kemnitz U, Artuc M . Transition from atherosclerosis to aortic aneurysm in humans coincides with an increased expression of RAS components. Atherosclerosis. 2009; 205(2):396-403. DOI: 10.1016/j.atherosclerosis.2009.01.003. View

12.

Kojima S, Suwa S, Fujiwara Y, Inoue K, Mineda Y, Ohta H . [Incidence and severity of coronary artery disease in patients with acute aortic dissection: comparison with abdominal aortic aneurysm and arteriosclerosis obliterans]. J Cardiol. 2001; 37(3):165-71. View

13.

Ayyash B, Tranquilli M, Elefteriades J . Femoral artery cannulation for thoracic aortic surgery: safe under transesophageal echocardiographic control. J Thorac Cardiovasc Surg. 2011; 142(6):1478-81. DOI: 10.1016/j.jtcvs.2011.04.005. View

14.

Silence J, Collen D, Lijnen H . Reduced atherosclerotic plaque but enhanced aneurysm formation in mice with inactivation of the tissue inhibitor of metalloproteinase-1 (TIMP-1) gene. Circ Res. 2002; 90(8):897-903. DOI: 10.1161/01.res.0000016501.56641.83. View

15.

Johnsen S, Forsdahl S, Singh K, Jacobsen B . Atherosclerosis in abdominal aortic aneurysms: a causal event or a process running in parallel? The Tromsø study. Arterioscler Thromb Vasc Biol. 2010; 30(6):1263-8. DOI: 10.1161/ATVBAHA.110.203588. View

16.

Ramanath V, Oh J, Sundt 3rd T, Eagle K . Acute aortic syndromes and thoracic aortic aneurysm. Mayo Clin Proc. 2009; 84(5):465-81. PMC: 2676130. DOI: 10.1016/S0025-6196(11)60566-1. View

17.

Kuzmik G, Sang A, Elefteriades J . Natural history of thoracic aortic aneurysms. J Vasc Surg. 2012; 56(2):565-71. DOI: 10.1016/j.jvs.2012.04.053. View

18.

Grainger D, Metcalfe J . Tamoxifen: teaching an old drug new tricks?. Nat Med. 1996; 2(4):381-5. DOI: 10.1038/nm0496-381. View

19.

Kempf K, Haltern G, Futh R, Herder C, Muller-Scholze S, Gulker H . Increased TNF-alpha and decreased TGF-beta expression in peripheral blood leukocytes after acute myocardial infarction. Horm Metab Res. 2006; 38(5):346-51. DOI: 10.1055/s-2006-925403. View

20.

Yokota M, Ichihara S, Lin T, Nakashima N, Yamada Y . Association of a T29-->C polymorphism of the transforming growth factor-beta1 gene with genetic susceptibility to myocardial infarction in Japanese. Circulation. 2000; 101(24):2783-7. DOI: 10.1161/01.cir.101.24.2783. View