Family history of aortic dissection ups risk of disorder, surgery

Individuals with a family history of aortic dissection (AD) are at high risk of developing AD and undergoing later aortic surgery than those with no family history, reveals a study.

The authors used the Taiwan National Health Insurance database to conduct both cross-sectional and cohort studies. They also used a registry parent–offspring relationship algorithm to reconstruct the genealogy of this population for heritability estimation. A total of 23,868 patients with an AD diagnosis in 2015 were included in the cross-sectional study.

The prevalence and adjusted relative risks (RRs) were assessed. The liability threshold model was used to examine the effects of heritability and environmental factors. To compare late outcomes in the cohort study, a 1:10 propensity score–matched cohort comprising AD patients with or without a family history of AD was included.

A family history of AD in first-degree relatives resulted in an RR of 6.82 (95 percent confidence interval [CI], 5.12–9.07). AD heritability was estimated to be 57.0 percent for genetic factors, 3.1 percent for shared environmental factors, and 40.0 percent for nonshared environmental factors.

Analysis excluding those with Marfan syndrome or bicuspid aortic valve revealed the association of a family history of AD with an RR of 6.56 (95 percent CI, 4.92–8.77) for AD. Patients with AD and a family history of AD also had a higher risk of later aortic surgery compared to those with AD without a family history (subdistribution hazard ratio, 1.40, 95 percent CI, 1.12–1.76).