Structure of comorbidity in ascending aortic aneurysm

Abstract

Aim. To analyze the comorbidity structure in patients with ascending thoracic aortic aneurysm (TAA) in the Siberian Federal District (SFD).Material and methods. The study included 163 patients (114 men (56,8±12,1 years) and 49 women (59,4±10,4 years)) with ascending TAA, who underwent open surgical treatment at the Cardiology Research Institute of the Tomsk National Research Medical Center. Concomitant pathologies were assessed on the basis of anamnesis and paraclinical investigations. Comparison of the prevalence of concomitant diseases in the group of patients with ascending TAA between men and women, as well as between patients ascending TAA in the SFD, other groups of patients with this pathology, population samples and patients with other cardiovascular diseases was performed using the χ2 test or Fisher’s exact test in the Statistiсa 12 program.Results. In patients with ascending TAA, hypertension (67,5%), bicuspid aortic valve (44,2%), coronary artery disease (38,6%), arrhythmia (31,3%), and heart failure (27,6%). Atherosclerosis of the aorta, coronary and carotid arteries occur with a prevalence of 12,9%, 16,6% and 5,5%, respectively. Among other forms of pathologies, the most common are connective tissue dysplasia (65,6%), obesity (12,3%), and chronic obstructive bronchitis (9,8%). In men with ascending TAA, myocardial infarction and atrial fibrillation are detected more often than women (11,4% and 20,2% vs 2% and 6,1%; p<0,05), and in women — carotid atherosclerosis and impaired cerebral circulation (12,2% and 18,4% vs 2,6% and 5,3%, p<0,05). Compared to other compared groups, aortic, coronary and carotid atherosclerosis, myocardial infarction, stroke, and type 2 diabetes were less frequently recorded in patients with ascending TAA in the SFD.Conclusion. Patients with ascending TAA in the SFD are characterized by a complex structure of comorbidity, including both cardiovascular pathologies and related risk factors, and other pathologies, including diseases of the lungs, kidneys, gastrointestinal tract, infectious and cancer diseases. To confirm the presence of inverse comorbidity between ascending TAA, atherosclerosis of other location, and type 2 diabetes, large-scale epidemiological, morphological, and molecular genetic studies are needed, which will reveal the fundamental mechanisms underlying it.

Keywords

• ascending aortic aneurysm
• concomitant diseases
• dystrophy