Abstract 19102: Association between Smoking and the Natural History of Renal and Cerebrovascular Fibromuscular Dysplasia: a Report of the United States Registry for FMD
Background: Fibromuscular dysplasia (FMD) is an uncommon arteriopathy. Smoking has previously been shown to be associated with earlier onset renal FMD and renal asymmetry. The association between smoking and the prevalence of cerebrovascular FMD or development of significant vascular events is unknown.
Methods: Demographics, medical history, presenting signs and symptoms, procedures, and major vascular events were queried from the US Registry for FMD and stratified according to smoking status. Major vascular event was defined as SAH, TIA, stroke, mesenteric ischemia, renal infarction, MI, or coronary revascularization.
Results: Of the 1003 patients enrolled at 14 centers as of 5/19/2014, 949 had information regarding smoking status and were included in this study. 327 (34.5%) had a history of smoking, of those 113 (11.9%) were current smokers. There was no significant difference among clinical outcomes stratified by current vs. former smoker therefore groups were combined. Clinical manifestations stratified by smoking status are shown in the Table. History of smoking was associated with older age at diagnosis, p=0.025. However there was no significant difference between smokers and nonsmokers in age of symptom onset. Significantly more patients with smoking history had an aneurysm, specifically involving the aorta and intracranial circulation, p<0.05. Patients with smoking history had more therapeutic vascular procedures, p=0.006. There was no difference in the rate of dissections between groups. Smoking history was associated with a higher frequency of major vascular events at enrollment but this was not statistically significant, p=0.077.
Conclusion: In contrast to previous studies, smoking was associated with later age of diagnosis for patients with renal and cerebrovascular FMD. Patients with smoking history had a higher frequency of aneurysms, especially aortic and intracranial and were more likely to undergo therapeutic intervention.
Author Disclosures: S. O’Connor: None. H. Gornik: None. J. Olin: None. J. Froehlich: None. X. Gu: None. J.M. Bacharach: None. B. Gray: None. B. Katzen: None. A. Sharma: None. R. McBane: None. M. Jaff: None. Y. Chi: None. P. Mace: None. S. Kim: None.
This research has received full or partial funding support from the American Heart Association
- © 2014 by American Heart Association, Inc.