Coronary artery disease and abdominal aortic aneurysm growth

Takagi, Hisato; Umemoto, Takuya

doi:10.1177/1358863x15624026

Cited by 14 publications

(10 citation statements)

References 47 publications

(120 reference statements)

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“…A recent meta-analysis by Li et al 2 of 10 epidemiological studies also showed that CAD was a risk factor for AAA (OR, 1.82; 95% CI, 1.65 to 2.00). Another recent meta-analysis 20 of 20 studies, however, demonstrated a statistically significant association of CAD with slower AAA growth rates (SMD, −0.06; 95% CI, −0.12 to −0.0027; p = 0.04).…”

Section: Discussionmentioning

confidence: 94%

“…Although CAD is positively associated with AAA presence, 1,2 it is negatively associated with AAA growth. 20 A previous meta-analysis by Cornuz et al 1 of six population-based risk factor studies of AAA showed that a history of myocardial infarction was a major risk factor or risk indicator for screening-detected AAA (OR, 2.30; 95% CI, 1.92 to 2.75). A recent meta-analysis by Li et al 2 of 10 epidemiological studies also showed that CAD was a risk factor for AAA (OR, 1.82; 95% CI, 1.65 to 2.00).…”

Section: Discussionmentioning

confidence: 99%

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Negative association of diabetes with rupture of abdominal aortic aneurysm

Takagi

Umemoto

2016

Diabetes and Vascular Disease Research

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Purpose: To summarize the association of diabetes with abdominal aortic aneurysm rupture, we reviewed currently available studies with a systematic literature search and meta-analytic evaluation. Methods: To identify all studies reporting the association of diabetes with abdominal aortic aneurysm rupture, MEDLINE and EMBASE were searched through July 2015. For each study, data regarding diabetes prevalence in both the ruptured and non-ruptured groups were used to generate an unadjusted odds ratio for abdominal aortic aneurysm rupture and 95% confidence intervals. Alternatively, an unadjusted or adjusted odds ratio, or hazard ratio for abdominal aortic aneurysm rupture with 95% confidence interval was directly abstracted (as available) from each individual study. Results: Our search identified 11 eligible studies. A primary meta-analysis of nine studies reporting data on ruptured (not including non-ruptured symptomatic) abdominal aortic aneurysm demonstrated that diabetes was associated with significantly lower prevalence/incidence of abdominal aortic aneurysm rupture (odds ratio/hazard ratio, 0.71; 95% confidence interval, 0.56 to 0.89; p = 0.003). A secondary meta-analysis of all 11 studies (adding two studies in which nonruptured symptomatic abdominal aortic aneurysm was included in the rupture group) also demonstrated that diabetes was associated with significantly lower prevalence/incidence of abdominal aortic aneurysm rupture (odds ratio/hazard ratio, 0.77; 95% confidence interval, 0.63 to 0.95; p = 0.01). Conclusion: Diabetes is negatively associated with abdominal aortic aneurysm rupture.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Negative association of diabetes with rupture of abdominal aortic aneurysm

Takagi

Umemoto

2016

Diabetes and Vascular Disease Research

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“…Even patients without any prior history of cardiac revascularization had significant lesions (found in 2 of every 5 subjects), and those already after PCI had significant lesions in as much as 4 in every 5 patients. It is still unclear whether this high association between the presence of AAA and atherosclerosis is causal or simply due to shared risk factors, as well as which risk factors contribute most to this phenomenon [8,26,27]. Coronary revascularization is an established method of reducing cardiovascular events, but interestingly, a randomized trial carried out in patients undergoing major vascular surgery failed to demonstrate the benefits of prophylactic CAD treatment for the clinical outcomes in patients with angiographically determined coronary artery stenosis [17,28].…”

Section: Discussionmentioning

confidence: 99%

Coexistence and management of abdominal aortic aneurysm and coronary artery disease

et al. 2020

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Background: Abdominal aortic aneurysm (AAA) and coronary atherosclerosis share common risk factors. In this study, a single-center management experience of patients with a coexistence of AAA and coronary artery disease (CAD) is presented. Methods: 271 consecutive patients who underwent elective AAA repair were reviewed. Coronary imaging in 118 patients was considered suitable for exploration of AAA coexistence with CAD. Results: Significant coronary stenosis (> 70%) were found in 65.3% of patients. History of cardiac revascularization was present in 26.3% of patients, myocardial infarction (MI) in 31.4%, and 39.8% had both. In a subgroup analysis, prior history of percutaneous coronary intervention (PCI) (OR = 6.9, 95% CI 2.6-18.2, p < 0.001) and patients' age (OR = 1.1, 95% CI 1.0-1.2, p = 0.007) were independent predictors of significant coronary stenosis. Only 52.0% (40/77) of patients with significant coronary stenosis underwent immediate coronary revascularization prior to aneurysm repair: PCI in 32 cases (4 drug-eluting stents and 27 bare metal stents), coronary artery bypass graft in 8 cases. Patients undergoing revascularization prior to surgery had longer mean time from coronary imaging to AAA repair (123.6 vs. 58.1 days, p < 0.001). Patients undergoing coronary artery evaluation prior to AAA repair had shorter median hospitalization (7 [2-70] vs. 7 [3-181] days, p = 0.007) and intensive care unit stay (1 [0-9] vs. 1 [0-70] days, p = 0.014) and also had a lower rate of major adverse cardiovascular events or multiple organ failure (0% vs. 3.9%, p = 0.035). A total of 11.0% of patients had coronary artery aneurysms. Conclusions: Patients with AAA might benefit from an early coronary artery evaluation strategy.

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“…The relationship between different diabetes treatments and AAA growth above or below the median value was examined using logistic regression. Three regression models were developed for cohorts 1 and 2: model 1 was unadjusted; model 2 was adjusted for risk factors consistently associated with AAA growth (initial AAA diameter, smoking history and ischaemic heart disease); model 3 was adjusted for risk factors or medications identified as being associated with median AAA growth in the univariable analyses ( P < 0·050) as well as those included in model 2. Owing to the small sample size in cohort 3, only models 1 and 2 were used.…”

Section: Methodsmentioning

confidence: 99%