Prevalence of abdominal aortic aneurysm and associated lower extremity artery aneurysm in men hospitalized for suspected or known cardiopulmonary disease

Abstract

BackgroundAAA is a disease affecting predominantly male patients ≥65 years and its dreaded complications such as rupture led to population-based screening programs as preventive measure. Nonetheless, the supposed prevalence may have been overestimated, so that targeted screening of high risk populations may be more effective.This study was performed to evaluate the prevalence of abdominal aortic aneurysm (AAA) of an inpatient high-risk cohort and to estimate the co-prevalence of lower extremity arterial aneurysms.MethodsParticipants: 566 male inpatients, ≥ 65 years of age, hospitalized for suspected or known cardiopulmonary disease.Primary and secondary outcome measures: Maximal infrarenal aortic diameters using abdominal ultrasound (leading edge to leading edge method). Upon detection of an AAA (diameter ≥ 30 mm), the lower extremity arteries were examined with regard to associated aneurysms.ResultsIn 40 of 566 patients (7.1%) AAAs were detectable. Fourteen patients (2.5%) had a first diagnosis of AAA, none of which was large (> 55 mm), the remaining 26 patients were either already diagnosed (14 patients, 2.5%) or previously repaired (12 patients, 2.1%).The three most common main diagnoses at discharge were acute coronary syndrome (43.3%), congestive heart failure (32.2%), and chronic obstructive pulmonary disease (12%). The cohort showed a distinct cardiovascular risk profile comprising arterial hypertension (82.9%), diabetes mellitus (44.4%), and a history of smoking (57.6%).In multivariate analysis, three-vessel coronary artery disease (Odds ratio (OR): 4.5, 95% confidence interval (CI): 2.3–8.9, p < 0.0001) and history of smoking (OR: 3.7, CI: 1.6–8.6, p < 0.01) were positively associated with AAA, while diabetes mellitus (OR: 0.5, CI: 0.2–0.9, p = 0.0295) showed a negative association with AAA.Among the subjects with AAA, we found two large iliac and two large popliteal aneurysms.ConclusionUltrasound screening in male inpatients, hospitalized for suspected or known cardiopulmonary disease, revealed a high AAA prevalence in comparison to the present epidemiological screening programs. There was a moderate proportion of newly-screen detected AAA and additional screening of the lower extremity arteries yielded some associated aneurysms with indication for possible intervention.

The Protective Effect of Metformin on Abdominal Aortic Aneurysm: A Systematic Review and Meta-Analysis

“…Abdominal aortic aneurysm (AAA) is characterized by the permanent dilation of the infrarenal segment of the aorta ( 1 ). The prevalence of AAA varied from 3.9 to 7.7% among developed countries in the 1980s and 1990s, and was decreased to 1-2% in recent years ( 2 ). In developing countries, however, AAA incidence has been increasing for the past few decades ( 2 ).…”

“…The prevalence of AAA varied from 3.9 to 7.7% among developed countries in the 1980s and 1990s, and was decreased to 1-2% in recent years ( 2 ). In developing countries, however, AAA incidence has been increasing for the past few decades ( 2 ). Due to the insidious nature of AAA, AAA is usually discovered accidentally by ultrasonography ( 3 ) or presents with catastrophic results like rupture, which accounts for 50-80% of mortality ( 4 ).…”

Expression gradient of metalloproteinases and their inhibitors from proximal to distal segments of abdominal aortic aneurysm

“…AAAs are the major cause of morbidity and mortality in ageing societies (Humphrey and Holzapfel 2012). Specifically, in the overall European population, the prevalence is 4.3-7,1%, with 80% mortality resulting from AAA rupture (Li et al 2013) (Hohneck et al 2019). In the Polish population aged over 65 years, the incidence of AAA is 2.62% and almost 4 times higher in men (4.32%) than in women (1.23%) (Mikołajczyk-Stecyna et al 2013;Tkaczyk et al 2019).…”

Association of impaired arterial wall properties with the presence of coronary artery disease in patients with abdominal aortic aneurysms

“…In asymptomatic CAD patients, higher PWV values were also associated with the progression of coronary atherosclerosis assessed by either coronary artery calcium (CAC) score or luminal stenosis on computed tomography coronary angiography (CCTA) . Moreover, severe CAD has been associated with presence of abdominal aneurysms . However, the association between increased PWV and presence of CAD in patients with abdominal aneurysms has not been investigated.…”

“…[13][14][15] Moreover, severe CAD has been associated with presence of abdominal aneurysms. 16 However, the association between increased PWV and presence of CAD in patients with abdominal aneurysms has not been investigated.…”