Cardiovascular risk factors and acute-phase response in idiopathic ascending aortitis: a case control study.
BACKGROUND
Idiopathic aortitis is a rare condition characterized by giant cell or lymphoplasmacytic inflammation of the aorta. The purpose of this study was to describe risk factors for the development of idiopathic aortitis.


METHODS
We conducted a case control study of 50 patients who were age-matched with two control subjects with non-inflammatory ascending aortic aneurysms. We examined whether the prevalences of gender, hypertension, hyperlipidemia, diabetes mellitus, smoking, family history of any aortic aneurysms, and elevated inflammatory markers differed between cases and controls.


RESULTS
The mean age of cases was 71.6 +/- 8.9 years and that of controls was 71.1 +/- 8.9 years. We found female gender (odds ratio [OR] 2.41, 95% confidence interval [CI] 1.20 to 4.85; P = 0.014) and active smoking (OR 3.37, 95% CI 1.12 to 10.08; P = 0.03) to be associated with idiopathic aortitis. The association with smoking persisted after adjustment for gender (OR 3.24, 95% CI 1.05 to 9.96; P = 0.04). There was a trend toward lower prevalence of diabetes mellitus in cases (OR 0.39, 95% CI 0.11 to 1.43; P = 0.16) but no difference in prevalences of other risk factors. The median pre-operative erythrocyte sedimentation rate (ESR) was 20 mm/hour in cases (n = 13) and 9 mm/hour in controls (n = 22). The median pre-operative C-reactive protein (CRP) levels were 12 mg/L in cases (n = 8) and 3 mg/L in controls (n = 6) (normal: <8 mg/L). A higher proportion of cases versus controls had elevations in ESR (38% versus 9%; P = 0.075) and CRP (62% versus 0%; P = 0.031).


CONCLUSIONS
Gender and smoking may interact in complex mechanisms with immune and proteolytic pathways in older, less distensible thoracic aortas. Elevated acute-phase reactants as a marker of systemic inflammation may be present in some patients.
Chowdhary
Vaidehi R
VR
Division of Rheumatology, Department of Medicine, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905, USA. chowdhary.vaidehi@mayo.edu
Crowson
Cynthia S
CS
Liang
Kimberly P
KP
Michet
Clement J
CJ
Miller
Dylan V
DV
Warrington
Kenneth J
KJ
Matteson
Eric L
EL
D000210:Acute-Phase Reaction / Q000150:complications; D000368:Aged; D001025:Aortitis / Q000150:complications* / Q000503:physiopathology; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000150:complications* / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking
D002097:C-Reactive Protein