Abdominal Aortic Aneurysms and Coronary Artery Disease in a Small Country with High Cardiovascular Burden

Al-Thani, Hassan; El‐Menyar, Ayman

doi:10.1155/2014/825461

Cited by 3 publications

(3 citation statements)

References 11 publications

(21 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5 Qatar, a neighboring country with similar demographics, has a significantly higher AAA prevalence of 5% in patients >80 years old. 33 It is yet unclear whether AAA in Saudi Arabia is underdiagnosed, or the prevalence is considerably smaller than international numbers. More research on this important topic is warranted.…”

Section: Discussionmentioning

confidence: 99%

Abdominal aorta measurements by a handheld ultrasound device compared with a conventional cart-based ultrasound machine

et al. 2021

View full text Add to dashboard Cite

BACKGROUND: Ultraportable or pocket handheld ultrasound devices (HUD) may be useful for large-scale abdominal aortic aneurysm screening. However, the reproducibility of measurements has not been compared with conventional cart-based ultrasound machines. OBJECTIVES: Investigate the intra- and inter-operator reproducibility of a HUD compared with a conventional ultrasound machine for aortic screening. DESIGN: Analytical, cross-sectional. SETTING: Ultrasound department at a large tertiary care hospital in Riyadh. PATIENTS AND METHODS: Eligible male participants aged ≥60 years were invited to participate upon arriving for a non-vascular ultrasound appointment. Three repeated anteroposterior measurements of the transverse aorta were made at the proximal and distal locations for each machine before repeating the measurements on a subset of participants by a second blinded operator. Intraclass correlation coefficients (ICC) and the Bland-Altman method were used to analyze reproducibility. MAIN OUTCOME MEASURE: Inter-system and intra- and inter-operator ICCs. SAMPLE SIZE: 114 males with repeated measurements by second operator on a subset of 35 participants. RESULTS: The median age (interquartile range) of participants was 68 years (62–74 years). The intra- and inter-operator ICCs were all >0.800 showing almost perfect agreement except for the inter-operator reproducibility at the proximal location using a conventional machine (ICC= 0.583, P =.007) and the Butterfly device (ICC=0.467, P =.037). The inter-system ICCs (95% CI) were 0.818 (0.736–0.874) and 0.879 (0.799–0.924) at the proximal and distal locations, respectively. The mean difference in aortic measurement between the ultrasound systems was 0.3 mm (1.7%) in the proximal location and 0.6 mm (3.6%) in the distal location. In total, >91% of the difference in measurements between the machines was <3 mm. The mean scanning time was 4:16 minutes for the conventional system and 3:53 minutes for the HUD ( P =.34). CONCLUSIONS: Abdominal aortic screening using a HUD was feasible and reliable compared with a conventional ultrasound machine. A pocket HUD should be considered for large-scale screening. LIMITATIONS: No cases of abdominal aortic aneurysm in the sample and lack of blinding. CONFLICT OF INTEREST: None.

show abstract

Section: Discussionmentioning

confidence: 99%

Abdominal aorta measurements by a handheld ultrasound device compared with a conventional cart-based ultrasound machine

et al. 2021

View full text Add to dashboard Cite

show abstract

“…In addition there was a higher mortality among persons with CAD and AAA when compared to persons with AAA but not CAD (47% vs 26%) [11]. In a study from Malaysia, the prevalence of undiagnosed AAA was 1.1% (95% CI 0.2-3.1).…”

Section: Risk Factorsmentioning

confidence: 96%

Association of Coronary Artery Disease and Abdominal Aortic Aneurysm – A Narrative Review

A¹

2021

RIJCCM

View full text Add to dashboard Cite

Studies have shown a strong association between coronary artery disease (CAD) and Abdominal Aortic Aneurysm (AAA). CAD is an independent predictor for developing AAA. The strong risk factors which were associated with the development of AAA were older age, male sex, hypertension, smoking, dyslipidemia, respiratory disease, cerebrovascular disease, claudication, and renal insuffi ciency in predicting the development of AAA. The prevalence of AAA among patients with angiographyverifi ed CAD was higher in men. It also increased to 8.6% in men aged above 65 years. They also found that 2.5% of patients with normal coronary profi le, 4.3% of patients with single vessel disease, 5.7% of patients with double vessel disease and 14.4% of patients with triple vessel disease on angiogram had AAA. The Pathological features like chronic infl ammation, degradation of the extracellular matrix and apoptosis of the vascular smooth muscle cells are common to both CAD and AAA. The vascular Smooth Muscle Cell (VSMC) plays an important role in the pathogenesis of coronary artery disease and aortic aneurysms. Another mechanism identifi ed in these VSMCs is the role of ubiquitin-like containing PHD and RING fi nger domains 1 (UHRF1) as the epigenetic master regulator of VSMC plasticity. Large symptomatic AAA with signifi cant CAD, a combined procedure should be the preferred approach. Asymptomatic AAA and CAD, a staged approach of CABG followed by AAA repair within two weeks should be performed to minimize the risk of AAA rupture. A one-time ultrasound screening for AAAs in men or women 65 to 75 years of age with a history of tobacco use, in fi rst-degree relatives of patients who present with an AAA, in men or women older than 75 years with a history of tobacco use is recommended.

show abstract

“…Cardiovascular risk stratification and management is of particular importance, as cardiac disease is manifest in approximately 36 per cent or more of the AAA population and, in the event of a postoperative myocardial infarction, a 41.2 per cent 1-year mortality rate is observed 13–16 . The National Institute for Health and Care Excellence (NICE) recommend that patients should be counselled on their risk of concomitant cardiovascular disease, and how this can be reduced through smoking cessation, lifestyle modification, optimization of medicines, and statin therapy 17–20 .…”

Section: Introductionmentioning

confidence: 99%

Sex-specific differences in the standard of care for infrarenal abdominal aortic aneurysm repair, and risk of major adverse cardiovascular events and death

Pouncey

Sweeting

Bicknell

et al. 2023

British Journal of Surgery

View full text Add to dashboard Cite

Background This study investigated whether sex-specific differences in preoperative/perioperative standard of care (SOC) account for disparity in outcomes after elective infrarenal abdominal aortic aneurysm repair. Methods This was a retrospective cohort study of elective infrarenal abdominal aortic aneurysm repairs (2013–2020) using depersonalized patient-level National Vascular Registry data. SOC was defined for waiting times, preoperative assessment (multidisciplinary/anaesthetic review), cardiovascular risk prevention, and perioperative medication. The primary outcome was major cardiovascular event and/or death (MACED). Results Some 21 810 patients with an infrarenal abdominal aortic aneurysm were included, 2380 women and 19 430 men. Women less often underwent aneurysm repair within SOC waiting times (51.5 versus 59.3 per cent; P < 0.001), but were equally likely to receive preoperative assessment (72.1 versus 72.5 per cent; P = 0.742). Women were less likely to receive secondary prevention for known cardiac disease (34.9 versus 39.6 per cent; P = 0.015), but more often met overall cardiovascular risk prevention standards (52.1 versus 47.3 per cent; P < 0.001). Women were at greater risk of MACED (open: 12.0 versus 8.9 per cent, P < 0.001; endovascular: 4.9 versus 2.9 per cent, P < 0.001; risk-adjusted OR 1.33, 95 per cent c.i. 1.12 to 1.59). A significant reduction in the odds of MACED was associated with preoperative assessment (OR 0.86, 0.75 to 0.98) and SOC waiting times (OR 0.78, 0.69 to 0.87). There was insufficient evidence to confirm a significant sex-specific difference in the effect of SOC preoperative assessment (women: OR 0.69, 0.50 to 0.97; men: OR 0.89, 0.77 to 1.03; interaction P = 0.170) or SOC waiting times (women: OR 0.84, 0.62 to 1.16; men: OR 0.76, 0.67 to 0.87; interaction P = 0.570) on the risk of MACED. Conclusion SOC waiting times and preoperative assessment were not met for both sexes, which was associated with an increased risk of MACED. Sex-specific differences in SOC attenuated but did not fully account for the increased risk of MACED in women.

show abstract

Abdominal Aortic Aneurysms and Coronary Artery Disease in a Small Country with High Cardiovascular Burden

Cited by 3 publications

References 11 publications

Abdominal aorta measurements by a handheld ultrasound device compared with a conventional cart-based ultrasound machine

Abdominal aorta measurements by a handheld ultrasound device compared with a conventional cart-based ultrasound machine

Association of Coronary Artery Disease and Abdominal Aortic Aneurysm – A Narrative Review

Sex-specific differences in the standard of care for infrarenal abdominal aortic aneurysm repair, and risk of major adverse cardiovascular events and death

Contact Info

Product

Resources

About