P083. Clinical Risk Factors Contributing to Five-Year Mortality in a VA Population with Ascending Thoracic Aortic Aneurysms
Presented During: POD Abstracts (Available for viewing in the exhibit hall for the duration of the meeting)
Santa Rosa, CA
United States - Contact Me
I am a current 3rd year medical student at Touro University, California. Originally from, Santa Rosa, CA, I attended Johns Hopkins University for my undergraduate and majored in Applied Mathematics and Statistics. I am very interested in pursuing a career in Cardiothoracic Surgery, specifically in heart failure and transplantation. My goal is to create a platform that fosters interdisciplinary innovation on how artificial intelligence (AI) and machine learning (ML) can be used in CT surgery.
Thursday, April 25, 2024: 5:38 PM - 7:00 PM
Sheraton Times Square
Room: Central Park
Description
Objective: To evaluate clinical risk factors contributing to five-year all cause death in a veteran population who have dilated ascending aorta or ascending thoracic aortic aneurysm (aTAA) and who did not undergo repair within five years.
Methods: 451 patients with ascending thoracic aortic size of at least 4.0cm or greater were identified. Fifty-eight pertinent risk factors (including social, genetic, cardiac risk factors, comorbidities, date of diagnosis and aneurysm size, date of most recent CT scan and aneurysm size, etc.) that may contribute to adverse outcomes were evaluated. Patients who died before repair within 5 years of aTAA identification or had 5 years of follow-up without repair were further analyzed. Statistical analysis used logistic regression for the outcome of five-year all-cause mortality with stepwise variable selection based on the Akaike information criterion. P<0.05 was considered statistically significant.
Results: Of 451 patients, 179 had ≥5 years follow-up without aTAA surgical repair. 46 out of the 179 patients (26%) died within 5 years. The variable selection process retained 21 of 58 covariates. Variables of clinical interest and statistical significance in the adjusted model were age (odds ratio 1.22 per year, p<0.001), history of prior open or endovascular procedures (OR 5.18, p=0.003), history of angiotensin receptor blocker (ARB) use (OR 0.13, p=0.008), and aneurysm size (OR 3.13 per cm, p=0.037).
Conclusion: Age, history of prior open or endovascular procedures, and aneurysm size increased the risk of all-cause death at 5 years. Among modifiable risk factors, only the use of ARB was protective in preventing five-year mortality. Although prior clinical trials of ARB use in patients with Marfan Syndrome did not find beneficial effects in humans, ARB use in the overall aneurysm population may be beneficial in reducing 5-year mortality and should be further investigated.
Authors
Vidur Kailash (1), Sally Tu (1), Siavash Zamirpour (1), Tiffany Cao (1), William Pace (1), Marko Boskovski (1), Liang Ge (1), Elaine Tseng (2)
Institutions
(1) University of California, San Francisco, San Francisco, CA, (2) UCSF and SFVA, South San Francisco, CA
Methods: 451 patients with ascending thoracic aortic size of at least 4.0cm or greater were identified. Fifty-eight pertinent risk factors (including social, genetic, cardiac risk factors, comorbidities, date of diagnosis and aneurysm size, date of most recent CT scan and aneurysm size, etc.) that may contribute to adverse outcomes were evaluated. Patients who died before repair within 5 years of aTAA identification or had 5 years of follow-up without repair were further analyzed. Statistical analysis used logistic regression for the outcome of five-year all-cause mortality with stepwise variable selection based on the Akaike information criterion. P<0.05 was considered statistically significant.
Results: Of 451 patients, 179 had ≥5 years follow-up without aTAA surgical repair. 46 out of the 179 patients (26%) died within 5 years. The variable selection process retained 21 of 58 covariates. Variables of clinical interest and statistical significance in the adjusted model were age (odds ratio 1.22 per year, p<0.001), history of prior open or endovascular procedures (OR 5.18, p=0.003), history of angiotensin receptor blocker (ARB) use (OR 0.13, p=0.008), and aneurysm size (OR 3.13 per cm, p=0.037).
Conclusion: Age, history of prior open or endovascular procedures, and aneurysm size increased the risk of all-cause death at 5 years. Among modifiable risk factors, only the use of ARB was protective in preventing five-year mortality. Although prior clinical trials of ARB use in patients with Marfan Syndrome did not find beneficial effects in humans, ARB use in the overall aneurysm population may be beneficial in reducing 5-year mortality and should be further investigated.
Authors
Vidur Kailash (1), Sally Tu (1), Siavash Zamirpour (1), Tiffany Cao (1), William Pace (1), Marko Boskovski (1), Liang Ge (1), Elaine Tseng (2)
Institutions
(1) University of California, San Francisco, San Francisco, CA, (2) UCSF and SFVA, South San Francisco, CA
Presentation Duration
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