ATLANTA — Patients with aortic dissection appear to have an increased burden of renal cysts, compared with healthy controls.
This finding in a case-control study raises the intriguing possibility that renal cysts could be a marker of increased risk for aortic dissection, Dr. Eun Kyung Kim observed at the meeting.
The mechanistic explanation for the observed association between renal cysts and aortic dissection might be that renal cysts are another manifestation of the same structural weakness of connective tissue that increases the risk of aortic dissection, according to Dr. Kim of Samsung Medical Center in Seoul, South Korea.
In a study of 659 patients with aortic dissection and 1,397 healthy control patients who underwent multidetector CT angiography as part of routine health screening, renal cysts were detected in 39% of the group with aortic dissection, compared with 22% of controls. Multivariate logistic regression analysis identified several independent predictors of aortic dissection: hypertension, associated with a 10.8-fold increased risk; smoking, with a 2.2-fold risk; renal cysts, with a 1.6-fold risk; and advancing age.
The presence of renal cysts was linked to aortic dissection most strongly in the subgroup of normotensive subjects over age 50. In this 105-patient cohort, renal cysts were associated with a 3.4-fold increased risk of aortic dissection.
The primary pathology of aortic dissection involves degenerative changes secondary to dysregulation of matrix metallo-proteinase (MMP) production, which results in matrix degradation. The pathology of renal cysts is less well worked out, but it appears to involve dysregulation of MMP-2 and MMP-9. The results of this case-control study must be considered hypothesis generating. A prospective study will be needed to establish whether renal cysts truly are a risk factor for aortic dissection, he said.
Disclosures: None was reported.