Fluoroquinolones increase susceptibility to aortic aneurysm and aortic dissection: Molecular mechanism and clinical evidence

• Published in: Vascular medicine (London, England) Vol. 28; no. 6; p. 604
• Main Authors: Xuan, Xuezhen, Li, Yaling, Cao, Genmao, Zhang, Ruijing, Hu, Jie, Jin, Haijiang, Dong, Honglin
• Format: Journal Article
• Language: English
• Published: England 01.12.2023
• Subjects: Aortic Aneurysm; Aortic Dissection - chemically induced; Fluoroquinolones - adverse effects; Humans; Inflammation; aortic aneurysm; fluoroquinolones; vascular smooth muscle cell; aortic dissection; extracellular matrix
• ISSN: 1477-0377
• DOI: 10.1177/1358863X231198055

Aortic aneurysm (AA) and aortic dissection (AD) are prevalent severe cardiovascular diseases that result in catastrophic complications and unexpected deaths. Owing to the lack of clinically established and effective medications, the only treatment options are open surgical repair or endovascular therapy. Most researchers have focused on the development of innovative medications or therapeutic targets to slow the progression of AA/AD or lower the risk of malignant consequences. Recent studies have shown that the use of fluoroquinolones (FQs) may increase susceptibility to AA/AD to some extent, especially in patients with aortic dilatation and those at a high risk of AD. Therefore, it is crucial for doctors, particularly those in cardiovascular specialties, to recognize the dangers of FQs and adopt alternatives. In the present review, the main clinical observational studies on the correlation between FQs and AA/AD in recent years are summarized, with an emphasis on the relative physiopathological mechanism incorporating destruction of the extracellular matrix (ECM), phenotypic transformation of vascular smooth muscle cells, and local inflammation. Although additional data are required, it is anticipated that the rational use of FQs will become the standard of care for the treatment of aortic diseases.