Prevalence and Trends of the Abdominal Aortic Aneurysms Epidemic in General Population - A Meta-Analysis

Li, Xi; Zhao, Ge; Zhang, Jian; Duan, Zhi-quan; Xin, Shijie

doi:10.1371/journal.pone.0081260

Cited by 183 publications

(170 citation statements)

References 76 publications

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“…The metaanalysis by Cornuz et al [16] of eight population-based risk factor studies of AAA showed that a history of PAD was a major risk factor or risk indicator for screening-detected AAA (OR, 2.48; 95% CI, 2.10 to 2.92). A meta-analysis by Li et al [17] of three epidemiological studies also showed that claudication was a risk factor for AAA (OR, 3.00; 95% CI, 1.74 to 5.19). However, although the association of PAD with AAA growth is still debated, PAD may be not [12] or even negatively [9,19] associated with AAA growth despite its positive association with AAA presence [16,17].…”

Section: Discussionmentioning

confidence: 94%

“…A meta-analysis by Li et al [17] of three epidemiological studies also showed that claudication was a risk factor for AAA (OR, 3.00; 95% CI, 1.74 to 5.19). However, although the association of PAD with AAA growth is still debated, PAD may be not [12] or even negatively [9,19] associated with AAA growth despite its positive association with AAA presence [16,17]. Bhak et al [12] found no independent association between claudication and AAA expansion rates (adjusted MD, -0.1 mm/year; 95% CI, -0.6 to 0.3 mm/year; P = 0.52).…”

Section: Discussionmentioning

confidence: 94%

“…Also, in the multivariate logistic regression analysis of a recent population-based AAA screening study (6,142 screened subjects including 469 AAA patients) by Chun et al [26], COPD was independently associated with AAA (adjusted OR, 1.75; 95% CI, 1.41 to 2.18; P < 0.001). Furthermore, a meta-analysis by Li et al [17] of six epidemiological studies also showed that respiratory disease was a risk factor for AAA (OR, 1.36; 95% CI, 1.19 to 1.55). However, the eight currently available studies [15,[28][29][30][31][32][33][34]] demonstrated a lack of association between COPD with AAA growth.…”

Section: Discussionmentioning

confidence: 95%

“…A discrepancy between the association of comorbidity with AAA presence and that of the same comorbidity with AAA growth, however, could be identifi ed. First, on the one hand, coronary artery disease (CAD) is positively associated with AAA presence [16,17]. A meta-analysis by Cornuz et al [16] 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 (odds ratio [OR], 2.30; 95% CI, 1.92 to 2.75).…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, peripheral artery disease (PAD) is also positively associated with AAA presence [16,17]. The metaanalysis by Cornuz et al [16] of eight population-based risk factor studies of AAA showed that a history of PAD was a major risk factor or risk indicator for screening-detected AAA (OR, 2.48; 95% CI, 2.10 to 2.92).…”

Section: Discussionmentioning

confidence: 99%

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The association between body mass index and abdominal aortic aneurysm growth: a systematic review

Takagi

Umemoto

2016

Vasa

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Summary: Diabetes, a state of relative insulin resistance, is negatively associated with both the presence and growth abdominal aortic aneurysms (AAA), which could suggest a protective role of obesity against AAA presence or growth. A recent meta-analysis demonstrated a trend toward a positive, though statistically non-signifi cant, association between body mass index (BMI) and the presence of AAA. With respect to the association between obesity and AAA growth, however, the evidence had been very limited. To determine whether obesity (or BMI) is associated with AAA growth, we reviewed currently available studies with a systematic literature search. Our comprehensive search identifi ed seven eligible studies reporting the association of BMI and AAA growth rates, which included data on a total of 3,768 AAA patients. All seven identifi ed studies demonstrated no association between BMI and AAA growth. Despite a trend toward a positive association between BMI and AAA presence, the reason why BMI is not associated with AAA growth (suggested in the present review) is unclear. A discrepancy between associated comorbidities (coronary artery disease, peripheral artery disease, and chronic obstructive pulmonary disease) and AAA presence and between the same comorbidities and AAA growth, however, could be identifi ed. Further investigations are required to elucidate why BMI is not associated with AAA growth despite the trend for a positive association with AAA presence.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The association between body mass index and abdominal aortic aneurysm growth: a systematic review

Takagi

Umemoto

2016

Vasa

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Screening for Abdominal Aortic Aneurysm

Force

Owens

Davidson

et al. 2019

JAMA

213

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IMPORTANCE An abdominal aortic aneurysm (AAA) is typically defined as aortic enlargement with a diameter of 3.0 cm or larger. The prevalence of AAA has declined over the past 2 decades among screened men 65 years or older in various European countries. The current prevalence of AAA in the United States is unclear because of the low uptake of screening. Most AAAs are asymptomatic until they rupture. Although the risk for rupture varies greatly by aneurysm size, the associated risk for death with rupture is as high as 81%.OBJECTIVE To update its 2014 recommendation, the USPSTF commissioned a review of the evidence on the effectiveness of 1-time and repeated screening for AAA, the associated harms of screening, and the benefits and harms of available treatments for small AAAs (3.0-5.4 cm in diameter) identified through screening.POPULATION This recommendation applies to asymptomatic adults 50 years or older. However, the randomized trial evidence focuses almost entirely on men aged 65 to 75 years.EVIDENCE ASSESSMENT Based on a review of the evidence, the USPSTF concludes with moderate certainty that screening for AAA in men aged 65 to 75 years who have ever smoked is of moderate net benefit. The USPSTF concludes with moderate certainty that screening for AAA in men aged 65 to 75 years who have never smoked is of small net benefit. The USPSTF concludes that the evidence is insufficient to determine the net benefit of screening for AAA in women aged 65 to 75 years who have ever smoked or have a family history of AAA. The USPSTF concludes with moderate certainty that the harms of screening for AAA in women aged 65 to 75 years who have never smoked and have no family history of AAA outweigh the benefits.RECOMMENDATIONS The USPSTF recommends 1-time screening for AAA with ultrasonography in men aged 65 to 75 years who have ever smoked. (B recommendation) The USPSTF recommends that clinicians selectively offer screening for AAA with ultrasonography in men aged 65 to 75 years who have never smoked rather than routinely screening all men in this group. (C recommendation) The USPSTF recommends against routine screening for AAA with ultrasonography in women who have never smoked and have no family history of AAA. (D recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for AAA with ultrasonography in women aged 65 to 75 years who have ever smoked or have a family history of AAA. (I statement)

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