Aortic mineralization triggers the risk of acute type B aortic dissection.

Autor: Cao L; Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing, 100853, China; Medical School of Chinese PLA, Beijing, China; Department of General Surgery, The 983rd Hospital of Joint Logistic Support Force of PLA, Tianjin, 300142, China., Zhang H; Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing, 100853, China., Niu Z; Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing, 100853, China; Medical School of Chinese PLA, Beijing, China., Ma T; Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing, 100853, China; Medical School of Chinese PLA, Beijing, China., Guo W; Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing, 100853, China. Electronic address: guoweiplagh@sina.com.
Jazyk: angličtina
Zdroj: Atherosclerosis [Atherosclerosis] 2024 Aug; Vol. 395, pp. 118519. Date of Electronic Publication: 2024 Jun 12.
DOI: 10.1016/j.atherosclerosis.2024.118519
Abstrakt: Background and Aims: The role of aortic mineralization in the pathogenesis of acute type B aortic dissection (TBAD) is unclear. Whether thoracic aortic calcification (TAC) and circulating alkaline phosphatase (ALP) activity are associated with acute TBAD risk remains elusive.
Methods: Observational and Mendelian randomization (MR) studies were conducted sequentially. Using propensity score matching (1:1) by age and sex, patients with acute TBAD (n = 125) were compared with control patients (n = 125). Qualitative (score) and quantitative (volume) analyses of the TAC burden on different thoracic aortic segments were conducted using non-enhanced computed tomography. Univariate and multivariate analyses were used to identify significant independent risk factors for TBAD and TAC burden, respectively. MR was finally used to determine the causal relationship between elevated ALP activity and TBAD risk.
Results: The qualitative and quantitative analyses revealed that TAC burden was significantly higher in the TBAD group, except for in the ascending aortic segment (both p < 0.05). Preoperative circulating ALP was significantly elevated in the TBAD group (p < 0.001). The elevated TAC burden score on the descending thoracic aortic segment (odds ratio [OR] 3.31, 95% confidence interval [CI] 1.31-8.37) and increased ALP activity (OR 1.03, 95% CI 1.01-1.06) was independently associated with TBAD risk. Interestingly, ALP was significantly positively associated with TAC burden, and MR analyses confirmed that ALP genetically predicted TBAD risk.
Conclusions: Elevated ALP may trigger TBAD risk via the increased volume of TAC. Aortic mineralization may not protect the aorta itself.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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