Clinical Characteristics of Patients With Fibromuscular Dysplasia With and Without Aneurysms in the Arcadia-Pol Study

Objective: Fibromuscular dysplasia (FMD) is idiopathic, segmental, non-inflammatory, non- atherosclerotic disease affecting small and medium-sized arteries. FMD causes artery stenosis, although it may also lead to aneurysm, dissection or arterial tortuosity. The aim of the study was to evaluate prevalence and clinical characteristics of patients with FMD and aneurysms. Design and method: The ARCADIA-Pol is an ongoing study, initiated in 2015 at the Department of Hypertension, National Institute of Cardiology in Warsaw, Poland. Patients enrolled in the study met the inclusion criteria: presence or suspicion of FMD and/or radiologically documented episode of spontaneous dissection of any artery. Each patient underwent: clinical and 24h ambulatory blood pressure monitoring, biochemical tests, echocardiography, US Doppler of renal and carotid arteries and whole body angio-CT. We present data of 435 currently enrolled patients. Results: Among 435 patients enrolled to the analysis FMD was confirmed in 281 patients. Out of 281 FMD patients, aneurysms were found in 32.7% subjects, most often in renal (14.6%), intracranial (11.7%) and splenic (10.7%) arteries. In every fourth patient with FMD the presence of aneurysm was detected during evaluation in the study. Most important 72.9% patients with newly diagnosed aneurysm were qualified to interventional treatment. In FMD patients with aneurysm mean age was 52.3±12.0 years, most patients were women (91.3%). In this group prevalence of HT was 85.9%, hyperlipidemia 47.8%, history of smoking 26.1% and history of contraceptive pills use among women 20.7%. Patients with FMD and aneurysm were significantly older as compared to groups of patients without aneurysms and included a significantly higher percentage of female as compared to other groups of patients. Women with FMD and aneurysm had more often history of contraceptive pills use than women without FMD. Conclusions: Aneurysms are relatively often found among patients with FMD (32.7%), most often in renal, cerebrovascular and splenic arteries. Radiological screening performed in ARCADIA-Pol study enabled to detect aneurysms in each fourth patient with FMD enrolled to the program, of which 72.9% were qualified to interventional treatment of aneurysm.