ABDOMINAL AORTIC ANEURYSMS AND CORONARY ARTERY DISEASE

  • Rita Soares Ferreira Serviço de Angiologia e Cirurgia Vascular, Hospital de Santa Marta, CHLC, Lisboa, Portugal; NOVA Medical School, Lisboa, Portugal
  • Rodolfo Ferreira Abreu Serviço de Angiologia e Cirurgia Vascular, Hospital de Santa Marta, CHLC, Lisboa, Portugal
  • Nelson Camacho Serviço de Angiologia e Cirurgia Vascular, Hospital de Santa Marta, CHLC, Lisboa, Portugal
  • Joana Catarino Serviço de Angiologia e Cirurgia Vascular, Hospital de Santa Marta, CHLC, Lisboa, Portugal
  • Ricardo Correia Serviço de Angiologia e Cirurgia Vascular, Hospital de Santa Marta, CHLC, Lisboa, Portugal
  • Frederico Bastos Gonçalves Serviço de Angiologia e Cirurgia Vascular, Hospital de Santa Marta, CHLC, Lisboa, Portugal; NOVA Medical School, Lisboa, Portugal
  • Maria Emília Ferreira Serviço de Angiologia e Cirurgia Vascular, Hospital de Santa Marta, CHLC, Lisboa, Portugal
Keywords: Aortic Aneurysm, Abdominal, Coronary Disease, Prevalence, Risk Factors, Mass Screening

Abstract

Abdominal aortic aneurysm (AAA) is a focal dilatation of at least 1,5 times the normal aortic diameter at the level of the renal arteries or, in absolute value, it is a diameter superior to 30 mm. The global prevalence is 2% in men older than 65 years, which is 4 times higher than the prevalence of AAA in women.

The major risk factors for AAA are smoking, age, ethnicity, male gender and familiar history. There is a known association between coronary artery disease and AAA, probably because they share similar risk factors.

The authors aim to perform a review about the association between these diseases and about the advantages of doing a screening in this subgroup of patients.

Besides AAAs are not a result or manifestation of atherosclerosis, neither a dose-response effect, the atherosclerosis seems to be an important risk factor to the development of AAA, hence the association between AAA and coronary artery disease. The AAA prevalence is significantly higher in patients with known coronary disease; it varies between 1,8 and 9,5% in the coronary disease subgroup comparing to 2% in general population. The severity of coronary disease also seems related to AAA prevalence.

However, there are no sufficient data to support AAA screening in this subgroup of patients, mainly because the decrease of morbidity and mortality with screening is not yet determined.

Downloads

Download data is not yet available.

References

1. Jahangir E, Lipworth L, Edwards TL, Kabagambe EK, Mumma MT,
Mensah GA, et al. Smoking, sex, risk factors and abdominal aortic
aneurysms: a prospective study of 18 782 persons aged above 65
years in the Southern Community Cohort Study. J Epidemiol Community
Health [Internet]. 2015;69(5):481–8. Available from: http://
www.ncbi.nlm.nih.gov/pubmed/25563744%5Cnhttp://www.
pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC4494088

2. Svensjö S, Björck M, Gürtelschmid M, Djavani Gidlund K, Hellberg A,
Wanhainen A. Low prevalence of abdominal aortic aneurysm among
65-year-old swedish men indicates a change in the epidemiology of
the disease. Circulation. 2011;124(10):1118–23.

3. No Title. Centers Dis Control Prev Natl Cent Heal Stat Underlying
cause death, 1999–2010 results [accessed 25 Jan 2014];CDC
WONDER On-line Database.

4. Thompson SG, Ashton HA, Gao L, Scott RAP. Screening men for
abdominal aortic aneurysm: 10 year mortality and cost effectiveness
results from the randomised Multicentre Aneurysm
Screening Study. BMJ [Internet]. 2009;338:b2307. Available
from: http://www.pubmedcentral.nih.gov/articlerender.
fcgi?artid=3272658&tool=pmcentrez&rendertype=abstract

5. Svensjö S, Björck M WA. Update on screening for abdominal aortic
aneurysm: a topical review. Eur J Vasc Endovasc Surg. 2014;48(6):659–67.

6. Senaratne JM, Raggi P. Screening for aortic aneurysms in patients
with coronary artery disease: should it be done? Expert Rev Cardiovasc
Ther [Internet]. 2015;13(7):735–7. Available from: http://www.
tandfonline.com/doi/full/10.1586/14779072.2015.1051036

7. Madaric J, Vulev I, Bartunek J, et al. Frequency of abdominal aortic
aneurysm in patients > 60 years of age with coronary artery
disease. Am J Cardiol 2005;96: 1214-16.

8. Elkalioubie A, Haulon S, Duhamel A, Rosa M, Rauch A, Staels
B, Susen S, Van Belle E DA. Meta-Analysis of Abdominal Aortic
Aneurysm in Patients With Coronary Artery Disease. Am J Cardiol.
2015;116(9):1451–6.

9. Ashton HA, Buxton MJ, Day NE, Kim LG, Marteau TM, Scott RA,
Thompson SG WNMASSG. The Multicentre Aneurysm Screening
Study (MASS) into the effect of abdominal aortic aneurysm screening
on mortality in men: a randomised controlled trial. Lancet.
2002;360(9345):1531–9.

10. Lederle FA, Johnson GR, Wilson SE, Chute EP, Hye RJ, Makaroun MS,
Barone GW, Bandyk D, Moneta GL, Makhoul RG. The aneurysm detection
and management study screening program: validation cohort and final
results: Aneurysm Detection and Management Veterans Af.

11. Darwood R, Earnshaw JJ, Turton G, Shaw E, Whyman M, Poskitt K, et
al. Twenty-year review of abdominal aortic aneurysm screening in
men in the county of Gloucestershire, United Kingdom. J Vasc Surg
2012;56:8e13.

12. Persson S-E, Boman K, Wanhainen A, Carlberg B, Arnerlöv C. Decreasing
prevalence of abdominal aortic aneurysm and changes in
cardiovascular risk factors. J Vasc Surg [Internet]. 2017;65(3):651–8.
Available from: http://dx.doi.org/10.1016/j.jvs.2016.08.091

13. Takagi H ATUT for the A (All-LI of CEG. Abdominal aortic aneurysm
screening reduces all-cause mortality: make screening great again.
Angiology. 2017;

14. McCaul KA, Lawrence-Brown M, Dickinson JA NP. Long term
outcomes of the Western Australian trial of screening for abdominal
aortic aneurysms. JAMA Int Med. 2016;176(1761):e7.

15. Rastreio oportunístico “Aorta não avisa.”

16. Castro-Ferreira R. Primeiro Rastreio de Base Populacional de Aneurisma
da Aorta Abdominal em Portugal: A Realidade dos Números. Commun
Present Best Commun 2016 SPACV Congr Figeuira da Foz, Port.

17. Lim LS, Haq N, Mahmood S, Hoeksema L, Surricchio M, Abraham-
-Katz R Ben, et al. Atherosclerotic cardiovascular disease screening
in adults: American College of Preventive Medicine position
statement on preventive practice. Am J Prev Med [Internet].
2011;40(3):381.e1-381.e10. Available from: http://dx.doi.
org/10.1016/j.amepre.2010.11.021

18. Toghill BJ, Saratzis A, Bown MJ. Abdominal aortic aneurysm—an independent
disease to atherosclerosis? Cardiovasc Pathol [Internet].
2017;27:71–5. Available from: http://dx.doi.org/10.1016/j.
carpath.2017.01.008

19. Shantikumar S, Ajjan R, Porter KE, Scott DJA. Diabetes and the Abdominal
Aortic Aneurysm. Eur J Vasc Endovasc Surg [Internet]. 2010;39(2):200–7.
Available from: http://dx.doi.org/10.1016/j.ejvs.2009.10.014

20. Golledge J, Moxon J, Pinchbeck J, Anderson G, Rowbotham S, Jenkins
J, Bourke M, Bourke B, Dear A, Buckenham T, Jones R NP. Association
between metformin prescription and growth rates of abdominal
aortic aneurysms. Br J Surg. 2017;104(11):1486–93.

21. Cho I-J, Heo R, Chang H-J, Shin S, Shim CY, Hong G-R, et al. Correlation
between coronary artery calcium score and aortic
diameter in a high-risk population of elderly male hypertensive
patients. Coron Artery Dis [Internet]. 2014;25(8):698–704.
Available from: http://www.scopus.com/inward/record.
url?eid=2-s2.0-84927690532&partnerID=tZOtx3y1

22. Durieux R, Van Damme H, Labropoulos N, Yazici A, Legrand V, Albert
A, et al. High Prevalence of abdominal aortic aneurysm in patients
with three-vessel coronary artery disease. Eur J Vasc Endovasc
Surg [Internet]. 2014;47(3):273–8. Available from: http://dx.doi.
org/10.1016/j.ejvs.2013.12.011

23. Cueff C, Keenan NG, Krapf L, Steg PG, Cimadevilla C, Ducrocq
G, Michel JB, Vahanian A M-ZD. Screening for abdominal aortic
aneurysm in coronary care unit patients with acute myocardial
infarction using portable transthoracic echocardiography. Eur Hear
J Cardiovasc Imaging. 2012;13(7):574–8.

24. Long A, Bui HT, Barbe C, Henni AH, Journet J, Metz D NP. Prevalence
of abdominal aortic aneurysm and large infrarenal aorta in patients
with acute coronary syndrome and proven coronary stenosis: a
prospective monocenter study. Ann Vasc Surg. 2010;24(5):602–8.

25. Dupont A, Elkalioubie A, Juthier F, Tagzirt M, Vincentelli A, Le
Tourneau T, Haulon S, Deklunder G, Breyne J, Susen S, Marechaux
S, Pinet F JB. Frequency of abdominal aortic aneurysm in
patients undergoing coronary artery bypass grafting. Am J Cardiol.
2010;105(11):1545–8.

26. Hernesniemi JA, Vänni V HT. The prevalence of abdominal aortic
aneurysm is consistently high among patients with coronary artery
disease. J Vasc Surg. 2015;62(1):232–40.

27. Takagi H UTA (All-LI of CEG. Coronary artery disease and abdominal
aortic aneurysm growth. Vasc Med. 2016;21(3):199–208.

28. Poon JT, Cheng SW, Wong JS TA. Prevalence of abdominal aortic
aneurysm in Chinese patients with severe coronary artery disease.
ANZ J Surg. 2010;80(9):630–3.

29. Lee SH, Chang SA, Jang SY, Lee SC, Song YB, Park SW, Choi SH, Gwon
HC, Oh JK KD. Screening for abdominal aortic aneurysm during transthoracic
echocardiography in patients with significant coronary
artery disease. Yonsei Med J. 2015;56(1):38–44.
Published
2019-05-15
Section
Review Article