Routine CBC-Derived Markers of Systemic Inflammation Are Associated With Growth of the Dilated Ascending Aorta During CT Surveillance

Red cell distribution width (RDW) is independently associated with 6-month growth of the native ascending aorta on CT, with OR 1.071 overall.

• Why it matters: Diameter-threshold surveillance misses many dissections, and inflammation may remodel the aortic wall even when size is below cutoffs. The study tests whether routine blood-count inflammation markers track ascending aortic enlargement.
• What they did: Adults with two CT scans 6 months apart (2000–2023) were analyzed using patient-level logistic regression and interval-level generalized estimating equations, adjusting for key clinical covariates. Growth was defined as a 2-mm mid-ascending diameter increase, using 95th-percentile marker values per patient and interval.
• The result: Among 3,262 patients (growth in 192, 10.2%), RDW remained significant at both patient and interval levels, while NLR and SII did not overall. In patients with guideline-defined dilation (40 mm), RDW, NLR, and SII were all associated with interval growth, but none were in aortas <40 mm.

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