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Coronary artery disease in patients with abdominal aortic aneurysm: a review article

J P Van Kuijk1, W J Flu, M Dunckelgrun

  • 1Department of Anesthesiology, Erasmus Medical Centre, The Netherlands.

The Journal of Cardiovascular Surgery
|January 31, 2009
PubMed

Insights

Abdominal aortic aneurysms (AAA) and coronary artery disease (CAD) share atherosclerosis but differ in prevalence, risk factors, and treatment outcomes. This review explores CAD characteristics in AAA patients, highlighting distinct pathophysiologies and risk profiles.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Surgery
  • Epidemiology

Background:

  • Abdominal aortic aneurysms (AAA) and coronary artery disease (CAD) were historically viewed as distinct vascular disorders with shared atherosclerotic origins.
  • Emerging evidence indicates significant differences in prevalence, risk profiles (gender, age, diabetes mellitus), and independent progression despite CAD treatment.
  • The stable prevalence of AAA contrasts with improved CAD outcomes, suggesting unique pathophysiological aspects.

Purpose of the Study:

  • To review and discuss the epidemiological characteristics of CAD in patients with AAA.
  • To elucidate the distinct and common pathophysiological pathways of AAA and CAD.
  • To examine the role of preoperative CAD testing and the influence of combined AAA and CAD treatment on long-term outcomes.

Main Methods:

  • Literature review focusing on epidemiological data, pathophysiology, risk profiles, diagnostic testing, and treatment strategies for AAA and CAD.
  • Comparative analysis of AAA and CAD characteristics, including risk factors and cardiovascular event influence.
  • Discussion of surgical and medical interventions for combined AAA and CAD management.

Main Results:

  • AAA and CAD exhibit differing prevalence rates and risk factor profiles, particularly concerning gender, age, and diabetes.
  • Despite advancements in CAD treatment, AAA prevalence remains unchanged, indicating distinct disease trajectories.
  • Preoperative assessment for CAD in AAA patients is crucial due to the significant impact of CAD on adverse outcomes.

Conclusions:

  • AAA and CAD, while sharing an atherosclerotic background, possess distinct epidemiological and pathophysiological characteristics.
  • Understanding these differences is vital for optimizing preoperative risk stratification and management strategies in patients with both conditions.
  • Combined treatment approaches for AAA and CAD require careful consideration to improve long-term patient outcomes.

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