Aortic & peripheral vascular disease
The Nonsyndromic Ascending Thoracic Aorta in a Population-Based Setting: A 5-Year Prospective Cohort Study
Authors' conclusion
In men aged 60 to 74 years, growth of the ascending aorta was slow, questioning the currently recommended (bi)annual surveillance scan intervals. Additionally, 95% of AAE case patients presented with diameters of <50.0 mm upon the event, highlighting the need for individualized risk stratifications in addition to diameter.
Study context
- Population
- Nonsyndromic DANCAVAS screening participants with ECG-gated noncontrast computed tomography (CT); excluded connective tissue disorders, bicuspid aortic valves and prior AAE survivors2,026 with consecutive CT
- Participants
- 14,962 participants
- Exposure
- Ascending aortic growth and adverse aortic events (AAEs) by baseline ascending aortic diameter
- Outcome
- Ascending aortic growth rates and adverse aortic events (thoracic aortic rupture, type A dissection, thoracic aortic-related death)
Methodological detailspopulation-based, multicenter, within the randomised DANCAVAS I and II trials
- Population-based
- Multicenter
- Within the randomised DANCAVAS I and II trials
Main finding
As reported in the abstract
Men
0.07
mean · SD 0.5 · mm/year
Women
0.13
mean · SD 0.3 · mm/year
<39.9 mm
0.11
SD 0.5 · mm/year
≥50 mm
0.07
SD 0.6 · mm/year
Men vs Women: P = 0.012 · ≥50 mm vs <39.9 mm: P = 0.60
- Men 45.0–49.9 mm progressing to ≥50.0 mm over 4.6 years
- 3.2%
Observational data: associations, not effects.
Further findings
| Outcome | <40.0 mm | 40.0–44.9 mm | 45.0–49.9 mm | ≥50.0 mm | Adjusted HR (95% CI) | P value | |
|---|---|---|---|---|---|---|---|
| Adverse aortic events by baseline diameter · median follow-up 5.0 yearsPer 1-mm increase in diameter | 0.1% | 0.2% | 1.4% | <3 events | 1.24 (1.16–1.33) | P < 0.001 | |
| 0.512Adjusted hazard ratio (log scale) |
Adverse aortic events by baseline diameter · median follow-up 5.0 years
| Adjusted HR (95% CI) | P value | ||
|---|---|---|---|
| Family history of aortic aneurysms | 5.43 (1.99–14.82) | P = 0.001 | |
| 0.050.21520Adjusted hazard ratio (log scale) |
- Adverse aortic events by baseline diameter — AAEs, whole cohort
- 23 (0.2%); 31/100,000 person-years
- Adverse aortic events by baseline diameter — Elective ascending aortic surgery
- 26 (0.2%)
Original publication
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