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

Abstract

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.