Mohammadmoradi Shayan, Heier Kory, Driehaus Elizabeth R, Alfar Hammodah R, Tyagi Sam, McQuerry Kristen, Whiteheart Sidney W
Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY, USA; Department of Molecular and Cellular Biochemistry, University of Kentucky, Lexington, KY, USA.
Department of Biostatistics, University of Kentucky, Lexington, KY, USA.
Atherosclerosis. 2025 Aug;407:119224. doi: 10.1016/j.atherosclerosis.2025.119224. Epub 2025 May 5.
Aortic aneurysms, including abdominal (AAA) and thoracic (TAA), pose significant challenges due to their rupture risk and complex pathophysiology. While aspirin has been proposed to manage aneurysm progression, evidence remains limited. This retrospective, single-center study used AI-driven methods to examine the association between aspirin therapy and aneurysm growth.
The study, at the University of Kentucky Healthcare, utilized de-identified electronic health record data from 2010 to 2023. To evaluate platelet count changes, Cohort 1 included patients with AAA or TAA and matched healthy controls. To evaluate aortic diameter, Cohort 2 included AAA or TAA patients who had at least two imaging studies. Extraction of aortic diameters utilized an advanced AI-based natural language processing (NLP) algorithm to identify and extract relevant text strings related to aortic dimensions. Multivariable-adjusted linear regression analyses assessed the impact of aspirin on aneurysm progression.
Cohort 1 included 11,538 participants: 5774 controls, 3439 with AAA, and 2325 with TAA. Platelet counts were significantly lower in patients with aortic aneurysms compared to controls, though they were not considered thrombocytopenic. Cohort 2 included 302 AAA and 141 TAA patients. Subgroup analysis revealed that aspirin use was associated with increased AAA progression in females with small aneurysms (<50 mm). Further, aspirin therapy showed no significant impact on the annualized change in aneurysm diameter for TAA or for males with AAA.
Our findings suggest aspirin's effectiveness varies by sex and potentially aneurysm size, underscoring the need for further research to refine antiplatelet therapy guidelines for aortic aneurysms.
主动脉瘤，包括腹主动脉瘤（AAA）和胸主动脉瘤（TAA），因其破裂风险和复杂的病理生理学而带来重大挑战。虽然有人提出使用阿司匹林来控制动脉瘤进展，但证据仍然有限。这项回顾性单中心研究采用人工智能驱动的方法来研究阿司匹林治疗与动脉瘤生长之间的关联。
该研究在肯塔基大学医疗中心进行，利用了2010年至2023年去识别化的电子健康记录数据。为评估血小板计数变化，队列1纳入了AAA或TAA患者以及匹配的健康对照。为评估主动脉直径，队列2纳入了至少有两项影像学检查的AAA或TAA患者。主动脉直径的提取利用了一种先进的基于人工智能的自然语言处理（NLP）算法来识别和提取与主动脉尺寸相关的相关文本字符串。多变量调整线性回归分析评估了阿司匹林对动脉瘤进展的影响。
队列1包括11,538名参与者：5774名对照、3439名AAA患者和2325名TAA患者。与对照组相比，主动脉瘤患者的血小板计数显著更低，不过他们未被视为血小板减少症患者。队列2包括302名AAA患者和141名TAA患者。亚组分析显示，在小动脉瘤（<50毫米）的女性中，使用阿司匹林与AAA进展增加有关。此外，阿司匹林治疗对TAA或AAA男性患者的动脉瘤直径年化变化没有显著影响。
我们的研究结果表明，阿司匹林的有效性因性别和潜在的动脉瘤大小而异，这突出了进一步研究以完善主动脉瘤抗血小板治疗指南的必要性。
