Key result
Preoperative coronary artery evaluation prior to abdominal aortic aneurysm repair was associated with a lower rate of major adverse cardiovascular events or multiple organ failure (0% vs. 3.9%, p=0.035).
Why the study?
Does preoperative coronary artery evaluation reduce perioperative complications in patients undergoing elective abdominal aortic aneurysm repair?
Cross-Sectional (n=271)
No
Does preoperative coronary artery evaluation reduce perioperative complications in patients undergoing elective abdominal aortic aneurysm repair?
Answers are grounded in this paper and cite their sources.
Preoperative coronary evaluation in AAA patients reveals a high prevalence of significant CAD and is associated with reduced perioperative complications and shorter hospital stays.
BACKGROUND: Abdominal aortic aneurysm (AAA) and coronary atherosclerosis share common risk factors. In this study, a single-center management experience of patients with a coexistence of AAA and coronary artery disease (CAD) is presented. METHODS: 271 consecutive patients who underwent elective AAA repair were reviewed. Coronary imaging in 118 patients was considered suitable for exploration of AAA coexistence with CAD. RESULTS: Significant coronary stenosis (> 70%) were found in 65.3% of patients. History of cardiac revascularization was present in 26.3% of patients, myocardial infarction (MI) in 31.4%, and 39.8% had both. In a subgroup analysis, prior history of percutaneous coronary intervention (PCI) (OR = 6.9, 95% CI 2.6-18.2, p < 0.001) and patients' age (OR = 1.1, 95% CI 1.0-1.2, p = 0.007) were independent predictors of significant coronary stenosis. Only 52.0% (40/77) of patients with significant coronary stenosis underwent immediate coronary revascularization prior to aneurysm repair: PCI in 32 cases (4 drug-eluting stents and 27 bare metal stents), coronary artery bypass graft in 8 cases. Patients undergoing revascularization prior to surgery had longer mean time from coronary imaging to AAA repair (123.6 vs. 58.1 days, p < 0.001). Patients undergoing coronary artery evaluation prior to AAA repair had shorter median hospitalization (7 [2-70] vs. 7 [3-181] days, p = 0.007) and intensive care unit stay (1 [0-9] vs. 1 [0-70] days, p = 0.014) and also had a lower rate of major adverse cardiovascular events or multiple organ failure (0% vs. 3.9%, p = 0.035). A total of 11.0% of patients had coronary artery aneurysms. CONCLUSIONS: Patients with AAA might benefit from an early coronary artery evaluation strategy.
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Hołda et al. (2018) conducted a cross-sectional in Abdominal aortic aneurysm and coronary artery disease (n=271). Preoperative coronary artery evaluation vs. No preoperative coronary artery evaluation was evaluated on Major adverse cardiovascular events (MACE) or multiple organ failure (MOF) (p=0.035). Preoperative coronary artery evaluation prior to abdominal aortic aneurysm repair was associated with a lower rate of major adverse cardiovascular events or multiple organ failure (0% vs. 3.9%, p=0.035).
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