Salome Weiss1, Indrani Sen2, Ying Huang2, Jill M Killian3, W Scott Harmsen3, Jay Mandrekar3, Alanna M Chamberlain3, Philip P Goodney4, Veronique L Roger5, Randall R DeMartino2. 1. Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn; Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, Bern, Switzerland. Electronic address: salome.weiss@insel.ch. 2. Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn. 3. Department of Health Sciences Research, Mayo Clinic, Rochester, Minn. 4. Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH. 5. Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn.
Abstract
OBJECTIVE: The nonaortic cardiovascular morbidity and mortality of patients with aortic dissection (AD), intramural hematoma (IMH), and penetrating aortic ulcer (PAU) is unknown. We aimed to define the rates of cardiovascular (CV) events in a cohort of patients with newly diagnosed AD, IMH, and PAU. METHODS: We performed a retrospective review of all Olmsted County, Minnesota, residents diagnosed with AD, IMH, and PAU from 1995 to 2015. The primary outcome was nonaortic CV death. The secondary outcome was a first-time nonfatal CV event (myocardial infarction, heart failure [HF], or stroke). The outcomes were compared with age- and sex-matched population referents using Cox proportional hazards regression, with adjustment for comorbidities. RESULTS: A total of 133 patients (77 with AD, 21 with IMH, 35 with PAU; 57% male) with a mean age of 71.8 ± 14.1 years were identified. The median follow-up was 10 years. Compared with the population referents, the patients with AD/IMH/PAU had an increased risk of CV death (adjusted hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.4-4.2; P = .003) and an increased risk of any first-time nonfatal CV event (adjusted HR, 3.0; 95% CI, 1.9-4.8; P < .001), mainly resulting from an increased risk of first-time HF (adjusted HR, 2.7; 95% CI, 1.7-4.3; P < .001). When excluding events within 14 days of the diagnosis, the patients with AD/IMH/PAU remained at increased risk of CV death (adjusted HR, 2.6; 95% CI, 1.4-4.7; P = .002), any first-time nonfatal CV event (adjusted HR, 2.6; 95% CI, 1.5-4.4, P <.001), and first-time HF (adjusted HR 2.5, 95% CI 1.5-4.3; P < .001). CONCLUSIONS: Compared with the population referents, the patients with AD/IMH/PAU had a two- to threefold risk of nonaortic CV death, any first-time nonfatal CV event, and first-time HF. These data implicate the need for long-term cardiovascular management for patients with AD/IMH/PAU.
OBJECTIVE: The nonaortic cardiovascular morbidity and mortality of patients with aortic dissection (AD), intramural hematoma (IMH), and penetrating aortic ulcer (PAU) is unknown. We aimed to define the rates of cardiovascular (CV) events in a cohort of patients with newly diagnosed AD, IMH, and PAU. METHODS: We performed a retrospective review of all Olmsted County, Minnesota, residents diagnosed with AD, IMH, and PAU from 1995 to 2015. The primary outcome was nonaortic CV death. The secondary outcome was a first-time nonfatal CV event (myocardial infarction, heart failure [HF], or stroke). The outcomes were compared with age- and sex-matched population referents using Cox proportional hazards regression, with adjustment for comorbidities. RESULTS: A total of 133 patients (77 with AD, 21 with IMH, 35 with PAU; 57% male) with a mean age of 71.8 ± 14.1 years were identified. The median follow-up was 10 years. Compared with the population referents, the patients with AD/IMH/PAU had an increased risk of CV death (adjusted hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.4-4.2; P = .003) and an increased risk of any first-time nonfatal CV event (adjusted HR, 3.0; 95% CI, 1.9-4.8; P < .001), mainly resulting from an increased risk of first-time HF (adjusted HR, 2.7; 95% CI, 1.7-4.3; P < .001). When excluding events within 14 days of the diagnosis, the patients with AD/IMH/PAU remained at increased risk of CV death (adjusted HR, 2.6; 95% CI, 1.4-4.7; P = .002), any first-time nonfatal CV event (adjusted HR, 2.6; 95% CI, 1.5-4.4, P <.001), and first-time HF (adjusted HR 2.5, 95% CI 1.5-4.3; P < .001). CONCLUSIONS: Compared with the population referents, the patients with AD/IMH/PAU had a two- to threefold risk of nonaortic CV death, any first-time nonfatal CV event, and first-time HF. These data implicate the need for long-term cardiovascular management for patients with AD/IMH/PAU.
Authors: James L Januzzi; Kim A Eagle; Jeanna V Cooper; Jianming Fang; Udo Sechtem; Truls Myrmel; Arturo Evangelista; Jae K Oh; Alfredo Llovet; Patrick T O'Gara; Christoph A Nienaber; Eric M Isselbacher Journal: J Am Coll Cardiol Date: 2005-08-16 Impact factor: 24.094
Authors: Véronique L Roger; Jill M Killian; Susan A Weston; Allan S Jaffe; Jan Kors; Paula J Santrach; Hugh Tunstall-Pedoe; Steven J Jacobsen Journal: Circulation Date: 2006-08-14 Impact factor: 29.690
Authors: Arturo Evangelista; Debabrata Mukherjee; Rajendra H Mehta; Patrick T O'Gara; Rossella Fattori; Jeanna V Cooper; Dean E Smith; Jae K Oh; Stuart Hutchison; Udo Sechtem; Eric M Isselbacher; Christoph A Nienaber; Linda A Pape; Kim A Eagle Journal: Circulation Date: 2005-02-14 Impact factor: 29.690
Authors: Ralph L Sacco; Scott E Kasner; Joseph P Broderick; Louis R Caplan; J J Buddy Connors; Antonio Culebras; Mitchell S V Elkind; Mary G George; Allen D Hamdan; Randall T Higashida; Brian L Hoh; L Scott Janis; Carlos S Kase; Dawn O Kleindorfer; Jin-Moo Lee; Michael E Moseley; Eric D Peterson; Tanya N Turan; Amy L Valderrama; Harry V Vinters Journal: Stroke Date: 2013-05-07 Impact factor: 7.914
Authors: V Riambau; D Böckler; J Brunkwall; P Cao; R Chiesa; G Coppi; M Czerny; G Fraedrich; S Haulon; M J Jacobs; M L Lachat; F L Moll; C Setacci; P R Taylor; M Thompson; S Trimarchi; H J Verhagen; E L Verhoeven; P Kolh; G J de Borst; N Chakfé; E S Debus; R J Hinchliffe; S Kakkos; I Koncar; J S Lindholt; M Vega de Ceniga; F Vermassen; F Verzini; P Kolh; J H Black; R Busund; M Björck; M Dake; F Dick; H Eggebrecht; A Evangelista; M Grabenwöger; R Milner; A R Naylor; J-B Ricco; H Rousseau; J Schmidli Journal: Eur J Vasc Endovasc Surg Date: 2017-01 Impact factor: 7.069
Authors: Randall R DeMartino; Indrani Sen; Ying Huang; Thomas C Bower; Gustavo S Oderich; Alberto Pochettino; Kevin Greason; Manju Kalra; Jill Johnstone; Fahad Shuja; W Scott Harmsen; Thanila Macedo; Jay Mandrekar; Alanna M Chamberlain; Salome Weiss; Philip P Goodney; Veronique Roger Journal: Circ Cardiovasc Qual Outcomes Date: 2018-08
Authors: Kwang Ree Cho; Anthony W Stanson; D Donald Potter; Kenneth J Cherry; Hartzell V Schaff; Thoralf M Sundt Journal: J Thorac Cardiovasc Surg Date: 2004-05 Impact factor: 5.209
Authors: Véronique L Roger; Susan A Weston; Margaret M Redfield; Jens P Hellermann-Homan; Jill Killian; Barbara P Yawn; Steven J Jacobsen Journal: JAMA Date: 2004-07-21 Impact factor: 56.272
Authors: Alina M Allen; Terry M Therneau; Kristin C Mara; Joseph J Larson; Kymberly D Watt; Sharonne N Hayes; Patrick S Kamath Journal: Am J Gastroenterol Date: 2019-11 Impact factor: 10.864
Authors: Francesco Squizzato; Meredith C Hyun; Indrani Sen; Mario D'Oria; Thomas Bower; Gustavo Oderich; Jill Colglazier; Randall R DeMartino Journal: Ann Vasc Surg Date: 2021-11-14 Impact factor: 1.607
Authors: Mario D'Oria; Indrani Sen; Courtney N Day; Jay Mandrekar; Salome Weiss; Thomas C Bower; Gustavo S Oderich; Philip P Goodney; Randall R DeMartino Journal: J Vasc Surg Date: 2020-07-30 Impact factor: 4.268