Screening for Abdominal Aortic Aneurysm in Elderly Male Patients with Coronary Artery Disease During Standard Transthoracic Echocardiography

Purpose: No studies on abdominal aortic aneurysm (AAA) screening in elderly male patients with coronary artery disease (CAD) in China have been conducted. This study aims to determine AAA prevalence, identify risk factors, and assess transthoracic echocardiography (TTE) as a screening modality to optimize screening strategies and enhance early diagnosis. Patients and Methods: This observational study prospectively enrolled male CAD patients aged ≥ 65 who had coronary angiography at Liaocheng People’s Hospital from January to June 2024. All underwent routine TTE with abdominal aortic diameter measurements for AAA screening. AAA prevalence was calculated, and clinical characteristics were compared using appropriate tests. Univariate and multivariate logistic regression analyses were done to find independent risk factors. Results: 384 elderly male CAD patients were included, all completing AAA screening via TTE in 2.1± 1.7 minutes on average. AAA was detected in 23 patients (6.0%), and 361 had no evidence. 4 AAA cases (17.4%) with aneurysms ≥ 50 mm were referred to vascular surgery. Multivariate analysis identified age, smoking history, hypertension, and multivessel coronary disease as independent risk factors. The overall AAA prevalence was 6.0% (23/384), and it was 16.8% (16/95) in patients with concurrent multivessel disease, hypertension, and smoking history. Conclusion: This study shows a relatively high AAA prevalence among elderly male CAD patients in China and identifies multivessel disease as a potential independent risk factor for the first time, although this finding should be interpreted cautiously. TTE, a non - invasive and easily implementable tool, is effective in AAA detection and suitable for routine cardiac evaluations of CAD patients. These findings provide a basis for AAA screening in this high - risk population, potentially improving early detection, reducing rupture risk, and enhancing patient outcomes.