Sex- and Age-Based Differences in Non-Syndromic Arteriopathies Amongst Younger Adults.

Abstract

Aneurysms are often associated with connective tissue disorders, but most occur sporadically and are non-syndromic. Manifestations of these non-syndromic arteriopathies across sexes and age groups have not been discussed extensively in the literature, especially in younger cohorts. We analyzed data from 84,496 patients in the Mayo Clinic Tapestry DNA Sequencing Study, excluding those with known vascular syndromes. Patients ≤ 60-years-old were included and grouped by sex and into five age groups (18-60). The odds and prevalence of various arteriopathies and complications (i.e. revascularization, stroke, dissection, and death) were compared. Overall, 909 patients ≤ 60 years-old were included with 68.0% females (mean age=47.49). Females were more likely to have carotid/cerebral aneurysms (55.2% vs 31.6%, p<0.0001), and males were more likely to have thoracic (50.9% vs 21.8%, p<0.0001) and abdominal aortic aneurysms (7.22% vs 2.59%, p<0.01). Males with splanchnic and carotid/cerebral aneurysms were more likely to dissect (58.14% vs 21.49% and 45.65% vs 30.79% p<0.05, respectively). Females were more likely to have multi-site aneurysms (16.34% vs 12.03%, p<0.05), with the most common being concurrent carotid/cerebral and splanchnic aneurysms. Both sexes showed peak dissection rates at ages 36-45, although males experienced more complications in older age groups (56-60) and females in younger ones (46-55). In conclusion, males are more susceptible to large vessel aneurysms and complications later in life, whereas females more frequently experience medium vessel aneurysms, complications earlier in life, and co-occurring multi-site aneurysms. Potential un-identified genetic factors could be influencing these patterns.