Asthma Associates With Human Abdominal Aortic Aneurysm and Rupture

Abstract

Objective Asthma and abdominal aortic aneurysms (AAA) both involve inflammation. It remains unknown whether these diseases interact. Approach and Results Databases analyzed included DNRP: a population-based nationwide case-control study included all patients with ruptured AAA (rAAA) and age- and sex-matched AAA controls without rupture in Denmark from 1996–2012. VIVA: Subgroup study of participants from the population-based randomized Viborg vascular screening trial. Asthmatic patients were categorized by hospital diagnosis, bronchodilator use, and the recorded use of other anti-asthma prescription medications. Logistic regression models were fitted to determine whether asthma associated with the risk of rAAA in DNRP, and an independent risk of having an AAA at screening in the VIVA trial. From the DNRP study, asthma diagnosed less than one year or six months before the index date increased the risk of AAA rupture before (odds ratio OR=1.60, 2.12) and after (OR=1.51, 2.06) adjusting for AAA comorbidities. Use of bronchodilators elevated the risk of AAA rupture from ever use to within 90 days from the index date, before (OR=1.10~1.37) and after (OR=1.10~1.31) adjustment. Patients prescribed anti-asthma drugs also showed an increased risk of rupture before (OR=1.12~1.79) and after (OR=1.09~1.48) the same adjustment. In VIVA, anti-asthmatic medication use associated with increased risk of AAA before (OR=1.45) or after adjustment for smoking (OR=1.45) or other risk factors (OR=1.46). Conclusions Recent active asthma increased risk of AAA and AAA-rupture. These findings document and furnish novel links between airway disease and AAA, two common diseases that share inflammatory aspects.

Two C‐C Family Chemokines, Eotaxin and RANTES, Are Novel Independent Plasma Biomarkers for Abdominal Aortic Aneurysm

“…Eotaxin was included in our analysis solely on the basis that it formed part of a broad (relatively unbiased) cytokine multiplex panel, and we had no a priori suggestion of a link with AAA. Intriguingly, however, acute asthma has recently been linked to AAA susceptibility and rupture, an observation that appears to indirectly validate our observed eotaxin‐AAA association.…”

Cysteinyl leukotriene receptor 1 antagonism prevents experimental abdominal aortic aneurysm

“…Since CysLT1 antagonists target both the inflammatory and proteolytic components of AAA pathogenesis, they would represent a drug candidate with a mode of action that has not yet been clinically tested. Furthermore, CysLT1 antagonists, typified by montelukast, are effective medications against human asthma, a disease which is experimentally and epidemiologically associated with AAA and rupture ( 37 , 38 ). It has also been observed that AAA and asthma share several pathophysiological similarities ( 39 , 40 ) and epidemiological data have revealed a positive correlation between use of montelukast and reduced cardiovascular risk in men ( 41 ).…”

Aortic Aneurysms

“…A previous systematic review and meta-analysis has shown an association between psoriasis and AAA. 13 Recently, retrospective cohort studies using Danish populations reported that psoriasis 14 and asthma 15 were associated with higher risk for AAA.…”