Clinical Research Papers:
Increased risk of malignancy in patients with an aortic aneurysm: a nationwide population-based retrospective study
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Jen-Chun Wang1,2, Wu-Chien Chien3,4,*, Chi-Hsiang Chung3,4,5, Wen-I Liao1, Chang-Huei Tsao3,6, Yung-Fu Wu3 and Shih-Hung Tsai1,*
1Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
2Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
3Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
4School of Public Health, National Defense Medical Center, Taipei, Taiwan
5Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
6Department of Microbiology and Immunology, National Defense Medical Center, Taipei, Taiwan
*These authors contributed equally to this work
Shih-Hung Tsai, email: [email protected]
Wu-Chien Chien, email: [email protected]
Keywords: aortic aneurysm, malignancy, transforming growth factor-β, Marfan syndrome, fibrillin
Received: March 15, 2017 Accepted: August 06, 2017 Published: August 11, 2017
Background: Cardiovascular disease and malignancy have numerous similarities and possible interactions, as these diseases share several risk factors, epidemiological features and biological signaling pathways. Data regarding the risk of malignancy in patients with aortic aneurysm (AA) are scarce. We aimed to determine whether patients with AA have an increased risk of malignancy.
Materials and Methods: The data for the nationwide population-based retrospective cohort study described herein were obtained from the Taiwan National Health Insurance Research Database (NHIRD). We selected adult patients who had been newly diagnosed with AA and were followed up between 2000 and 2010. We excluded patients who had been diagnosed with AA and malignancy prior to the date of the AA diagnosis. The control cohort was selected from individuals who had no history of AA and was selected with 1:4 matching according to co-morbidities and medication history. The outcome was a diagnosis of malignancy and the cumulative incidence of AA.
Results: A total of 10,933 patients diagnosed with AA were identified. The patients with an AA had a significantly higher cumulative risk of developing malignancies in subsequent years than the patients without an AA (log rank test < 0.001). Similarly, patients with malignancies had a significantly higher cumulative risk of developing an AA in subsequent years than patients without malignancies (log rank test < 0.001).
Conclusions: Patients with an AA were shown to have a substantially increased risk of developing a variety of malignancies compared with patients without AAs. Healthcare professionals should be aware of this increased risk when treating patients with AAs.
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