{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T23:09:38Z","timestamp":1793574578567,"version":"4.5.0"},"reference-count":35,"publisher":"Georg Thieme Verlag KG","issue":"03\/04","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"vor","delay-in-days":205,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aorta (Stamford)"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We aim to better define the association between thoracic aortic aneurysm (TAA) and giant cell arteritis (GCA), thereby enhancing cross-diagnosis, monitoring, and therapy.<\/jats:p>\n                  <jats:p>Literature review: We used a two-step search approach to the available literature on the relationship between TAA and GCA. First, databases including PubMed, Web of Science, and Embase were searched. Additionally, relevant studies were identified through secondary sources including references of initially selected articles.<\/jats:p>\n                  <jats:p>Retrospective cohort study: We identified patients at our institution who were diagnosed with both TAA and GCA from January 1980 through December 2024. Descriptive statistics were used to support the association between these two diseases described in the literature.<\/jats:p>\n                  <jats:p>The literature review disclosed an increased incidence and relative risk of TAA among patients with GCA. GCA patients experienced progressive aortic enlargement, which may be due to vascular inflammation and disruption of elastin and collagen fiber biology in the vessel wall, resulting in mechanical weakness. Progressive aortic enlargement, including the aortic annulus, often results in aortic insufficiency (AI); in surgery, complete aortic replacement is recommended. Predictors of aneurysmal disease included AI and severe inflammatory response at the time of GCA diagnosis, as well as risk factors such as male sex, hypertension, hyperlipidemia, coronary disease, diabetes, and smoking.<\/jats:p>\n                  <jats:p>The investigation at our institution revealed that among 2,344 patients with GCA, 72 developed TAA, an incidence of 3.1%. Among those, 61 (84.7%) had an ascending aortic aneurysm, 5 (6.9%) had a descending aortic aneurysm, and 6 (8.3%) had both. Of these, 33 (45.8%) were male, 66 (91.7%) had hypertension, 44 (61.1%) were former or current smokers, 16 (22.2%) had diabetes mellitus, 66 (91.7%) had hyperlipidemia, 31 (43.1%) had coronary disease, 33 (45.8%) had concomitant polymyalgia rheumatica, and 21 (29.2%) had AI at the time of GCA diagnosis.<\/jats:p>\n                  <jats:p>Our study highlights a 3.1% incidence of TAA in GCA patients, with hypertension, smoking, and hyperlipidemia as the most common additional risk factors. Ascending aortic aneurysms were the most frequent, occurring in 84.7% of TAA in GCA cases. These findings emphasize the importance of monitoring for TAA in the GCA population.<\/jats:p>","DOI":"10.1055\/a-2765-8610","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:12:53Z","timestamp":1766535173000},"page":"072-078","source":"Crossref","is-referenced-by-count":4,"title":["Thoracic Aortic Aneurysm and Giant Cell Arteritis: Clarifying the Link"],"prefix":"10.1055","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3418-4296","authenticated-orcid":false,"given":"Sebastien","family":"Strachan","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Aortic Institute at Yale-New Haven, Yale School of Medicine, New Haven, Connecticut, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad A.","family":"Zafar","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Aortic Institute at Yale-New Haven, Yale School of Medicine, New Haven, Connecticut, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudhir","family":"Perincheri","sequence":"additional","affiliation":[{"name":"Department of Pathology, Yale School of Medicine, New Haven, Connecticut, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awab","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Aortic Institute at Yale-New Haven, Yale School of Medicine, New Haven, Connecticut, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nafiye Busra","family":"Celik","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Aortic Institute at Yale-New Haven, Yale School of Medicine, New Haven, Connecticut, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mah I. Kan","family":"Changez","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Aortic Institute at Yale-New Haven, Yale School of Medicine, New Haven, Connecticut, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bulat A.","family":"Ziganshin","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Aortic Institute at Yale-New Haven, Yale School of Medicine, New Haven, Connecticut, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Elefteriades","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Aortic Institute at Yale-New Haven, Yale School of Medicine, New Haven, Connecticut, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"issue":"09","key":"ref2","doi-asserted-by":"crossref","first-page":"103411","DOI":"10.1016\/j.autrev.2023.103411","article-title":"Persistent aortic inflammation in patients with giant cell arteritis","volume":"22","author":"M S Kaymakci","year":"2023","journal-title":"Autoimmun Rev"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1097\/01.md.0000145366.40805.f8","article-title":"Aortic aneurysm and dissection in patients with biopsy-proven giant cell arteritis from northwestern Spain: a population-based study","volume":"83","author":"M A Gonzalez-Gay","year":"2004","journal-title":"Medicine (Baltimore)"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1136\/annrheumdis-2012-202145","article-title":"Should I send my patient with previous giant cell arteritis for imaging of the thoracic aorta? A systematic literature review and meta-analysis","volume":"73","author":"S L Mackie","year":"2014","journal-title":"Ann Rheum Dis"},{"issue":"07","key":"ref5","doi-asserted-by":"crossref","first-page":"502","DOI":"10.7326\/0003-4819-122-7-199504010-00004","article-title":"Increased incidence of aortic aneurysm and dissection in giant cell (temporal) arteritis. A population-based study","volume":"122","author":"J M Evans","year":"1995","journal-title":"Ann Intern Med"},{"issue":"10","key":"ref6","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1002\/art.1780371020","article-title":"Thoracic aortic aneurysm and rupture in giant cell arteritis. A descriptive study of 41 cases","volume":"37","author":"J M Evans","year":"1994","journal-title":"Arthritis Rheum"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1097\/WNO.0000000000000538","article-title":"Is routine imaging of the aorta warranted in patients with giant cell arteritis?","volume":"37","author":"J J Chen","year":"2017","journal-title":"J Neuroophthalmol"},{"issue":"07","key":"ref8","doi-asserted-by":"crossref","first-page":"2931","DOI":"10.1093\/rheumatology\/keab871","article-title":"Increased risk of thoracic aortic complications among patients with giant cell arteritis: a nationwide, population-based cohort study","volume":"61","author":"P Therkildsen","year":"2022","journal-title":"Rheumatology (Oxford)"},{"issue":"12","key":"ref9","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1136\/ard-2022-223480","article-title":"2022 American College of Rheumatology\/EULAR classification criteria for giant cell arteritis","volume":"81","author":"C Ponte","year":"2022","journal-title":"Ann Rheum Dis"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1136\/annrheumdis-2013-204113","article-title":"The relative risk of aortic aneurysm in patients with giant cell arteritis compared with the general population of the UK","volume":"74","author":"J C Robson","year":"2015","journal-title":"Ann Rheum Dis"},{"issue":"12","key":"ref11","doi-asserted-by":"crossref","first-page":"3522","DOI":"10.1002\/art.11353","article-title":"Incidence and predictors of large-artery complication (aortic aneurysm, aortic dissection, and\/or large-artery stenosis) in patients with giant cell arteritis: a population-based study over 50 years","volume":"48","author":"D M Nuenninghoff","year":"2003","journal-title":"Arthritis Rheum"},{"issue":"10","key":"ref12","doi-asserted-by":"crossref","first-page":"1826","DOI":"10.1136\/annrheumdis-2013-203322","article-title":"Prospective long term follow-up of a cohort of patients with giant cell arteritis screened for aortic structural damage (aneurysm or dilatation)","volume":"73","author":"A Garc\u00eda-Mart\u00ednez","year":"2014","journal-title":"Ann Rheum Dis"},{"issue":"03","key":"ref13","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1002\/art.23315","article-title":"Development of aortic aneurysm\/dilatation during the follow-up of patients with giant cell arteritis: a cross-sectional screening of fifty-four prospectively followed patients","volume":"59","author":"A Garc\u00eda-Mart\u00ednez","year":"2008","journal-title":"Arthritis Rheum"},{"issue":"08","key":"ref14","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1093\/rheumatology\/ken119","article-title":"Relationship between fluorodeoxyglucose uptake in the large vessels and late aortic diameter in giant cell arteritis","volume":"47","author":"D Blockmans","year":"2008","journal-title":"Rheumatology (Oxford)"},{"issue":"03","key":"ref15","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.jbspin.2010.09.013","article-title":"Aortic involvement in giant cell arteritis: current data","volume":"78","author":"M Bossert","year":"2011","journal-title":"Joint Bone Spine"},{"issue":"06","key":"ref16","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1007\/s00259-004-1757-9","article-title":"The value of [18F]FDG-PET in the diagnosis of large-vessel vasculitis and the assessment of activity and extent of disease","volume":"32","author":"M A Walter","year":"2005","journal-title":"Eur J Nucl Med Mol Imaging"},{"issue":"30","key":"ref17","doi-asserted-by":"crossref","first-page":"e4146","DOI":"10.1097\/MD.0000000000004146","article-title":"Positron emission tomography and computed tomography angiography for the diagnosis of giant cell arteritis: a real-life prospective study","volume":"95","author":"D Lariviere","year":"2016","journal-title":"Medicine (Baltimore)"},{"issue":"26","key":"ref18","doi-asserted-by":"crossref","first-page":"e3851","DOI":"10.1097\/MD.0000000000003851","article-title":"18F-fluorodeoxyglucose positron emission tomography and the risk of subsequent aortic complications in giant-cell arteritis: a multicenter cohort of 130 patients","volume":"95","author":"H de Boysson","year":"2016","journal-title":"Medicine (Baltimore)"},{"issue":"14","key":"ref19","first-page":"e27","article-title":"2010 ACCF\/AHA\/AATS\/ACR\/ASA\/SCA\/SCAI\/SIR\/STS\/SVM Guidelines for the diagnosis and management of patients with thoracic aortic disease. A Report of the American College of Cardiology Foundation\/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine","volume":"55","author":"L F Hiratzka","year":"2010","journal-title":"J Am Coll Cardiol"},{"issue":"08","key":"ref20","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1002\/art.41774","article-title":"2021 American College of Rheumatology\/Vasculitis Foundation guideline for the management of giant cell arteritis and Takayasu arteritis","volume":"73","author":"M Maz","year":"2021","journal-title":"Arthritis Rheumatol"},{"issue":"01","key":"ref21","first-page":"140","article-title":"Thoracic aorta involvement in giant cell arteritis: a case-control analysis of morphological data at diagnosis","volume":"38","author":"F Rodrigues","year":"2020","journal-title":"Clin Exp Rheumatol"},{"issue":"07","key":"ref22","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1136\/annrheumdis-2011-200865","article-title":"Large vessel involvement in biopsy-proven giant cell arteritis: prospective study in 40 newly diagnosed patients using CT angiography","volume":"71","author":"S Prieto-Gonz\u00e1lez","year":"2012","journal-title":"Ann Rheum Dis"},{"issue":"05","key":"ref23","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1002\/art.23577","article-title":"Aortic involvement in recent-onset giant cell (temporal) arteritis: a case-control prospective study using helical aortic computed tomodensitometric scan","volume":"59","author":"C Agard","year":"2008","journal-title":"Arthritis Rheum"},{"issue":"03","key":"ref24","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1097\/MD.0b013e3181a68ae2","article-title":"Long-term follow-up of aortic involvement in giant cell arteritis: a series of 48 patients","volume":"88","author":"I Marie","year":"2009","journal-title":"Medicine (Baltimore)"},{"issue":"01","key":"ref25","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s13075-020-02396-5","article-title":"Symptomatic aortitis at giant cell arteritis diagnosis: a prognostic factor of aortic event","volume":"23","author":"O Espitia","year":"2021","journal-title":"Arthritis Res Ther"},{"issue":"03","key":"ref26","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1080\/03009742.2020.1786855","article-title":"Incidence and predictors of thoracic aortic damage in biopsy-proven giant cell arteritis","volume":"50","author":"M J Koster","year":"2021","journal-title":"Scand J Rheumatol"},{"issue":"06","key":"ref27","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1016\/j.semarthrit.2018.10.003","article-title":"Aortic dilatation in patients with large vessel vasculitis: a longitudinal case control 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Rheum"},{"issue":"06","key":"ref33","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/S0049-0172(95)80010-7","article-title":"Aortic and extracranial large vessel giant cell arteritis: a review of 72 cases with histopathologic documentation","volume":"24","author":"J T Lie","year":"1995","journal-title":"Semin Arthritis Rheum"},{"issue":"01","key":"ref34","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.athoracsur.2005.01.063","article-title":"Annuloaortic ectasia and giant cell arteritis","volume":"80","author":"S Gelsomino","year":"2005","journal-title":"Ann Thorac Surg"},{"issue":"12","key":"ref35","doi-asserted-by":"crossref","first-page":"1989","DOI":"10.1136\/annrheumdis-2012-202408","article-title":"Large-vessel involvement in giant cell arteritis: a population-based cohort study of the incidence-trends and prognosis","volume":"72","author":"T A Kermani","year":"2013","journal-title":"Ann Rheum 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