Key result
Among male patients requiring coronary intervention, the overall prevalence of abdominal aortic aneurysms was 8.5%, which significantly increased with coronary heart disease severity (P=0.037).
Why the study?
Declining AAA prevalence has challenged general screening programs, prompting reevaluation of AAA prevalence in male CHD patients to assess the need for targeted ultrasound screening.
Does targeted ultrasound screening detect a high prevalence of abdominal aortic aneurysms in male patients with coronary heart disease requiring intervention?
Cross-Sectional (n=1,000)
No
Does targeted ultrasound screening detect a high prevalence of abdominal aortic aneurysms in male patients with coronary heart disease requiring intervention?
Male patients with coronary heart disease requiring intervention have a high prevalence of abdominal aortic aneurysms (8.5%), suggesting targeted ultrasound screening may be warranted in this population.
May warrant targeted AAA screening consideration in men with severe CHD; leaves open whether it improves outcomes.
Summary: Background: Since the prevalence of abdominal aortic aneurysms (AAA) in Europe has declined to about 2.5%, general screening programs of elderly men are being called into question. On the other hand, other vascular diseases (e.g. coronary heart disease, CHD) are associated with a higher prevalence of AAA. This might have an impact on future targeted AAA screening programs. This study aimed to reevaluate the current prevalence of AAA in male patients with CHD, in order to assess whether CHD patients should be offered a targeted AAA ultrasound screening program. Patients and methods: The SCAN (Screening Cardiovascular Patients for Aortic Aneurysms) study prospectively evaluated the AAA prevalence in 1000 consecutive male CHD patients (70.1 ± 11.2 years) requiring any coronary intervention at an university hospital. All patients received transverse and longitudinal ultrasound scans of the abdominal aorta. Aortic diameter was assessed using the outer-to-outer measurement-technique. Primary endpoint was the prevalence of AAA. Secondary outcomes included stratification in 1-, 2-, or 3-vessel CHD. Results: AAA was detected in 85 patients (median diameter 38 mm, range 30–80 mm), corresponding to an overall prevalence of 8.5%. AAA prevalence was significantly associated with CHD severity: 5.6% in 1-vessel, 7.1% in 2-vessel, and 10.8% in 3-vessel CHD (P = 0.037). The multivariable analysis showed, that age per 10 years increase (OR 1.5, 95% CI 1.2–1.9, P = 0.001) and hyperlipidemia (OR 2.2, 95% CI 1.3–3.8, P = 0.003) were significantly associated with an AAA. The likelihood to be diagnosed with an AAA was significantly lower in non-smokers (OR 0.24, 95% CI, P < 0.001). Conclusions: This study confirms that CHD requiring any type of coronary intervention is strongly associated with AAA in male patients. AAA prevalence increases with CHD severity. Since the AAA prevalence is still significantly higher than in the general population, targeted ultrasound screening should be considered for all CHD patients.
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Reutersberg et al. (2020) conducted a cross-sectional in Coronary heart disease (n=1,000). Coronary heart disease requiring intervention was evaluated on Prevalence of abdominal aortic aneurysms (AAA). Among male patients requiring coronary intervention, the overall prevalence of abdominal aortic aneurysms was 8.5%, which significantly increased with coronary heart disease severity (P=0.037).
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