Matsubara Kazuyoshi, Fukuhara Natsumi, Hoshina Katsuyuki, Miyahara Kazuhiro, Suhara Masamitsu, Taniguchi Ryosuke, Matsukura Mitsuru, Takayama Toshio
Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Front Surg. 2022 Feb 24;9:808383. doi: 10.3389/fsurg.2022.808383. eCollection 2022.
Arterial deterioration is mostly caused by atherosclerosis, which progresses with age. However, we have observed serious backgrounds or etiologies in younger patients with non-atherosclerotic diseases and deterioration of small-to-medium-sized arterial lesions. Therefore, we aimed to identify the specific features of patients aged <40 years with deterioration of small-to-medium-sized arteries.
We selected patients who were admitted to our department from 1995 to 2019 with deterioration of small-to-medium-sized arteries (aneurysms, dissection, rupture, or arterial injury/damage) and focused on the cohort aged <40 years. We examined the backgrounds or etiologies of the patients including genetic and inflammatory diseases, which might have caused the arterial deterioration.
Consequently, more than half (54.1%) of the patients aged <40 years had non-atherosclerotic comorbid diseases. However, the number of deteriorated arterial lesions was higher in patients aged <40 years than in patients aged ≥40 years (3.13 vs. 1.33 lesion/patient; = 0.011). Furthermore, the data analysis of patients with multiple arterial lesions (≥3) revealed that the younger population tended to have more specific backgrounds or etiologies, notably Ehlers-Danlos syndrome and Behçet's disease. There were no differences in the all-cause mortality and cardiovascular disease-related mortality between patients aged <40 and ≥40 years ( = 0.89 and 0.29, respectively).
Over 50% of patients aged <40 years with deterioration of small-to-medium-sized arteries had non-atherosclerotic, specific clinical backgrounds or etiologies, including genetic and inflammatory diseases. In addition, they exhibited more arterial lesions than older patients.
动脉病变主要由动脉粥样硬化引起，且随年龄增长而进展。然而，我们在患有非动脉粥样硬化性疾病且中小动脉病变恶化的年轻患者中观察到了严重的背景因素或病因。因此，我们旨在确定年龄小于40岁的中小动脉病变恶化患者的具体特征。
我们选取了1995年至2019年期间因中小动脉病变（动脉瘤、夹层、破裂或动脉损伤）入住我科的患者，并重点关注年龄小于40岁的队列。我们检查了可能导致动脉病变恶化的患者背景因素或病因，包括遗传性和炎性疾病。
结果显示，年龄小于40岁的患者中超过一半（54.1%）患有非动脉粥样硬化性合并症。然而，年龄小于40岁的患者的动脉病变数量高于年龄大于或等于40岁的患者（3.13个病变/患者对1.33个病变/患者；P = 0.011）。此外，对有多发性动脉病变（≥3个）的患者进行数据分析发现，年轻人群往往有更特殊的背景因素或病因，尤其是埃勒斯-当洛综合征和白塞病。年龄小于40岁和年龄大于或等于40岁的患者在全因死亡率和心血管疾病相关死亡率方面没有差异（分别为P = 0.89和0.29）。
年龄小于40岁的中小动脉病变恶化患者中，超过50%有非动脉粥样硬化性的、特殊的临床背景因素或病因，包括遗传性和炎性疾病。此外，他们的动脉病变比老年患者更多。
