Key result
Exposure to fluoroquinolones was associated with a 62% higher long-term risk of developing aortic aneurysm or dissection compared to non-exposure (adjusted HR 1.62).
Why the study?
Although the connection between fluoroquinolones and aortic aneurysm or aortic dissection has been acknowledged, the full extent of long-term risks remains uncertain.
Does exposure to fluoroquinolones increase the long-term risk of aortic aneurysm and dissection?
Cohort (n=465,104)
Does exposure to fluoroquinolones increase the long-term risk of aortic aneurysm and dissection?
Fluoroquinolone use is associated with a 62% increased long-term risk of aortic aneurysm and dissection, underscoring the need for careful risk-benefit evaluation when prescribing these antibiotics.
Fluoroquinolone exposure was associated with higher long-term AA/AD risk; leaves open whether this warrants prescribing caution pending prospective confirmation.
The connection between fluoroquinolones and severe heart conditions, such as aortic aneurysm (AA) and aortic dissection (AD), has been acknowledged, but the full extent of long-term risks remains uncertain. Addressing this knowledge deficit, a retrospective cohort study was conducted in Taiwan, utilizing data from the National Health Insurance Research Database spanning from 2004 to 2010, with follow-up lasting until 2019. The study included 232,552 people who took fluoroquinolones and the same number of people who didn't, matched for age, sex, and index year. The Cox regression model was enlisted to calculate the hazard ratio (HR) for AA/AD onset. Additionally, five machine learning algorithms assisted in pinpointing critical determinants for AA/AD among those with fluoroquinolones. Intriguingly, within the longest follow-up duration of 16 years, exposed patients presented with a markedly higher incidence of AA/AD unexposed patients (80 vs. 30 per 100,000 person-years). After adjusting for multiple factors, exposure to fluoroquinolones was linked to a higher risk of AA/AD (HR 1.62, 95%CI 1.45-1.78). Machine learning identified ten factors that significantly affected AA/AD risk in those exposed. The findings illustrate a 62% elevation in the long-term risk of adverse outcomes associated with AA/AD following the administration of fluoroquinolones and concurrently delineate the salient factors contributing to AA/AD, underscoring the imperative for healthcare practitioners to meticulously evaluate the implications of prescribing these antibiotics in light of the associated risks and determinants.
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Wang et al. (2025) conducted a cohort in Aortic aneurysm and aortic dissection (n=465,104). Fluoroquinolones vs. Non-fluoroquinolone exposure was evaluated on New onset of aortic aneurysm (AA) or aortic dissection (AD) (HR 1.62, 95% CI 1.45-1.78, p=<0.001). Exposure to fluoroquinolones was associated with a 62% higher long-term risk of developing aortic aneurysm or dissection compared to non-exposure (adjusted HR 1.62).
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