Smoking and Adverse Outcomes in Fibromuscular Dysplasia

O’Connor, Sarah; Gornik, Heather L.; Froehlich, James B.; Gu, Xiaokui; Gray, Bruce H.; Mace, Pamela; Sharma, Aditya; Olin, Jeffrey W.; Kim, Esther S.H.

doi:10.1016/j.jacc.2016.01.058

Cited by 33 publications

(28 citation statements)

References 5 publications

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“…1,2 Distinct from atherosclerotic processes, FMD shares few typical cardiovascular risk factors aside from an association with tobacco smoking. 3,4 The most common variant of FMD is the multifocal type, with the affected arteries resembling a string of beads due to alternating regions of stenosis and dilation. 1,5 FMD can also cause a singular stenosis (focal type FMD) and has more recently been associated with fi ndings of arterial tortuosity, aneurysm, and dissection.…”

Section: ■ Distinct From Atherosclerosismentioning

confidence: 99%

“…8,9 Table 1 highlights key fi ndings and lessons learned from registry publications, many of which have altered previous concepts of this disease. 3,7,8,[10][11][12] ■ EPIDEMIOLOGY AND PATHOPHYSIOLOGY…”

Section: ■ the Us Registry For Fmdmentioning

confidence: 99%

“…7 Studies have reported an increased risk of FMD in patients with a history of tobacco smoking. 3,24 A US Registry report notes that FMD patients with a history of smoking had a statistically signifi cant higher rate of aneurysm than those who had never smoked (24.8% vs 18.9%), and there was a trend toward increased prevalence of major vascular events in smokers, including subarachnoid hemorrhage, transient ischemic attack, stroke, mesenteric ischemia, renal infarction, and major coronary event. 3 This study also found that patients with FMD who were smokers were more likely to have claudication symptoms (15.1% vs 7.4%) or to have undergone a vascular procedure (45.9% vs 36.7%).…”

Section: Risk Factors For Fmd: Female Sex and Tobacco Smokingmentioning

confidence: 99%

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Fibromuscular dysplasia: Advances in understanding and management

Brinza

Gornik

2016

CCJM

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Several key findings in recent years have reshaped our understanding of fibromuscular dysplasia (FMD), an uncommon nonatherosclerotic disease of medium-sized arteries that affects mainly women. While the true prevalence of this disease remains unknown, studies suggest that more people may be affected than previously reported. Better understanding of the clinical manifestations and natural history of FMD and advances in diagnostic imaging have altered the clinical approach to managing patients with this uncommon vascular disease. Although there are a multitude of unanswered questions regarding FMD, this review highlights recent insights and how this information has modified clinical care for those affected.

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Section: ■ Distinct From Atherosclerosismentioning

confidence: 99%

Section: ■ the Us Registry For Fmdmentioning

confidence: 99%

Section: Risk Factors For Fmd: Female Sex and Tobacco Smokingmentioning

confidence: 99%

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Fibromuscular dysplasia: Advances in understanding and management

Brinza

Gornik

2016

CCJM

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“…К патогенным факторам, выявленным у пациентов с многоочаговой ФМД, отнесли табакокурение, по-Fibromuscular Dysplasia of the Coronary Arteries Фибромускулярная дисплазия коронарных артерий скольку изменения сосудов и осложнения (аневризма, диссекция) в группе курильщиков появлялись в более молодом возрасте по сравнению с некурящими пациентами [20].…”

Section: этиологические факторыunclassified

Modern Concepts of Fibromuscular Dysplasia of the Coronary Arteries

Трисветова

2019

Racionalʹnaâ farmakoterapiâ v kardiologii

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Fibromuscular dysplasia of the coronary arteries is a rare non-atherosclerotic and non-inflammatory vascular lesion that is asymptomatic until serious complications develop: stenosis, dissection, rupture, sudden cardiac death. Since there are no long-term numerous clinical observations of patients with fibromuscular dysplasia of the coronary arteries, recommendations have not been developed for diagnosing and treating the disease, which often manifests with acute coronary syndrome. In 2014, the European Consensus was published, and in 2019, the first international consensus document on the diagnosis and treatment of fibromuscular dysplasia with lesions of vessels from different regions (renal, cerebrovascular, coronary, and others). The documents state that the development of fibromuscular dysplasia of the coronary arteries considers the participation of the PHACTR1 gene mutation and the transcriptional activity of the EDN1 gene, smoking, prolonged exertion of the vascular wall, and possibly female sex hormones. In the case of acute coronary syndrome, the most informative diagnostic method is computed tomography with angiography, which reveals a smooth narrowing of the lumen in the middle or distal section in the epicardial artery, often due to intramural hematoma, and also finds dissection, spasm, and tortuous vessel. Additional diagnostic methods ‒ intravascular ultrasound and optical coherence tomography allow differentiation of fibromuscular dysplasia with atherosclerosis of the coronary artery, vasculitis, and other diseases. The choice of treatment tactics for fibromuscular dysplasia of the coronary arteries depends on the severity of the clinical manifestations ‒ conservative medical treatment and interventional methods are used.

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“…A recent study from the United States FMD Registry found that FMD patients who smoke are more likely to have aneurysms, more likely to experience leg pain with exertion (claudication), more likely to require some type of vascular intervention, and as a whole are more likely to experience major vascular events such as stroke or heart attack compared to patients who have never smoked. 5 What are the common symptoms of FMD?…”

Section: What Causes Fmd?mentioning

confidence: 99%