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Prevalence of abdominal aortic aneurysms in patients undergoing coronary artery bypass
L Bergersen1, M S Kiernan, G McFarlane
1Division of Vascular and Transplant Surgery, University of Vermont College of Medicine, Burlington, USA.
Insights
Patients undergoing bypass grafting (CABG) have a higher prevalence of abdominal aortic aneurysms (AAA). Screening for AAA in CABG patients, especially older males who smoke, is recommended.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Diagnostic Imaging
Background:
- Coronary artery disease (CAD) and abdominal aortic aneurysms (AAA) are common vascular conditions.
- The prevalence of CAD in AAA patients is well-documented.
- The prevalence of AAA in patients with severe CAD undergoing coronary artery bypass grafting (CABG) is largely unknown.
Purpose of the Study:
- To determine the prevalence of abdominal aortic aneurysms (AAA) in patients with severe coronary artery disease undergoing bypass grafting (CABG).
Main Methods:
- Preoperative aortic ultrasound (US) screening was performed on 192 patients scheduled for elective CABG.
- A control group of 140 patients without cardiovascular disease also underwent US.
- An AAA was defined as a maximal diameter >= 3.0 cm.
Main Results:
- The overall prevalence of AAA in CABG patients was 18.2%.
- The prevalence of new AAA cases was 13.0% in CABG patients versus 1.4% in controls (p = 0.0001).
- Significant risk factors for AAA in the CABG population included age >= 65 years and smoking.
Conclusions:
- Patients undergoing CABG exhibit a significantly higher prevalence of abdominal aortic aneurysms (AAA) compared to controls.
- This study suggests a potential screening recommendation for AAA in patients undergoing CABG, particularly older, smoking males.
Abstract:
Although several studies describe the prevalence of coronary artery disease in patients with abdominal aortic aneurysms (AAA), the opposite relationship is virtually unexplored. It is the purpose of this study to determine the prevalence of AAA in patients with severe coronary artery disease undergoing bypass grafting (CABG). Patients scheduled for elective CABG underwent aortic ultrasound (US) preoperatively. A control group of patients without cardiovascular disease also underwent US. An AAA was defined as a maximal diameter > or =3.0 cm. US was performed on 192 CABG patients and 140 controls. The overall prevalence (previously repaired AAA and new cases) of AAA in CABG patients was 18.2%. The prevalence of new cases of AAA was 13.0% compared to 1.4% in controls (p = 0.0001). Ten patients had an AAA greater than 5.0 cm in size (5.2%). Logistic regression identified age > or =65 years and smoking as significant risk factors for AAA in the CABG population. The higher prevalence of AAA in CABG patients was confirmed by a case-control analysis of 73 age-matched patients. This study provides the first convincing evidence that the prevalence of AAA is higher in patients undergoing CABG than in the control population in Vermont. Consideration should be given to screening patients for AAA who are undergoing CABG, particularly older, smoking males.