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.