Abstract 15936: Fluoroquinolones and the Risk of Aortopathy: A Systematic Review and Meta-Analysis

Introduction:Recent studies have raised concern that fluoroquinolone use is associated with an increased risk of aortopathy, including aortic aneurysm with and without dissection. We performed a meta-analysis with a comprehensive literature review to further investigate this association.Hypothesis:Increased risk aortopathy with use of fluoroquinolone.Methods:This analysis was conducted per PRISMA guidelines. PubMed, Cochrane library, ClinicalTrials.gov, Embase, web of science and Google Scholar were searched for studies including adult (age > 18 years), patients exposed to fluoroquinolones or control antibiotics (amoxicillin/Any other antibiotic) for urinary tract infection or pneumonia with a primary outcome of aortic aneurysm or dissection. Data was extracted in predefined tables and meta-analysis was performed using random effects model. Heterogeneity was calculated using Q statistic and I2. The main summary estimate was Relative Risk with 95% confidence intervals (CI) as shown in figure.Results:Seven studies (2 retrospective, 1 longitudinal cohort, 1 nested case control, 1 nationwide cohort, 1 case time control, and 1 case cross-over study) with 59% males were included. Our analysis showed increased combined risk of development of AA and AD with quinolone exposure when compared with controls (relative risk [RR] (95% confidence interval [CI]) = 2.11 (1.62 - 2.75),I2=83.700). Individual RR for aortic aneurysm (RR of 2.83 (95% confidence interval [CI]) = 2.02 - 3.95,I2=89.150)) and AD (RR of 1.99 (95% confidence interval [CI]) = 1.23-3.06), I2=71.33) were also significantly increased.Conclusion:Compared to other antibiotics, use of fluoroquinolones was associated with significantly higher risk of aortic aneurysm and dissection combined.