Key result
Among 213 patients with emergently operated abdominal aortic aneurysms, 45% had known coronary artery disease and all had been seen by a physician within a year prior to presentation.
Observational (n=213)
Patients presenting with ruptured AAA frequently have known CAD and recent healthcare contact, suggesting missed opportunities for selective AAA screening.
Potential missed AAA screening opportunities in known CAD patients with recent visits; leaves open whether selective screening reduces emergent repairs.
BACKGROUND AND AIMS: Two thirds of patients with an abdominal aortic aneurysm (AAA) have relevant coronary artery disease (CAD). AAAs are prevalent in up to 16% of smokers with CAD. General screening of AAA is controversial. Aim was to assess the potential of finding AAA prior to rupture among patients with known CAD. Main endpoint was whether AAA could have been found during follow-up by sonography or at other time of cardiovascular evaluation. MATERIAL AND METHODS: Retrospective study. 213 consecutive, formerly unknown emergently operated AAAs, treated emergently for symptoms (n = 91) or rupture (n = 122) (rAAA) between January 1998 and June 2005. Patient charts were analysed and primary care physicians contacted. RESULTS: At presentation, mean age was 71 (+/-9) years, twenty (9%) were female. AAA had a mean diameter of 7.6 cm. Two thirds (143) were clinically obese (BMI 27 +/-5). 137 (64%) were active smokers, 32 (15%) had diabetes, 151 (71%) were hypertensive, and 80 (38%) received statin treatment. CAD had been diagnosed in 95 (45%) 9 years earlier and followed up. Thirty-five (16%) had had myocardial infarction. Echocardiography had been performed in 52 (24%). Thirty day mortality after open surgery was 25 (21%). CONCLUSION: All patients with rAAA had been seen by a GP or cardiologist within a year prior to presentation. The cost effectiveness of selective AAA screening should be evaluated in a larger study.
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Savolainen et al. (2010) conducted an observational in Abdominal aortic aneurysm (AAA) (n=213). Known coronary artery disease (CAD) was evaluated on Whether AAA could have been found during follow-up by sonography or at other time of cardiovascular evaluation. Among 213 patients with emergently operated abdominal aortic aneurysms, 45% had known coronary artery disease and all had been seen by a physician within a year prior to presentation.
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