An Association between Chronic Obstructive Pulmonary Disease and Abdominal Aortic Aneurysm beyond Smoking

Meijer, C. Arnoud; Kokje, V.B.C.; Tongeren, R.B.M. van; Hamming, Jaap F.; Bockel, J.H. van; Möller, Gertrude M.; Lindeman, J.

doi:10.1016/j.ejvs.2012.05.016

Cited by 46 publications

(37 citation statements)

References 25 publications

(21 reference statements)

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“…In PAD patients, a relatively severe progression of atherosclerotic disease is therefore likely to be responsible for the similar survival compared to the much older AAA patients, and the poor prognosis compared to the matched general population. Of note, COPD-related death was more frequent among AAA patients, which may be due to a common -genetically determined-defect in the extracellular matrix [28,29]. This further supports the divergence in pathophysiology between aneurysmal and occlusive vascular disease.…”

Section: Discussionsupporting

confidence: 58%

Peripheral artery disease patients may benefit more from aggressive secondary prevention than aneurysm patients to improve survival

et al. 2016

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a b s t r a c tBackground and aims: Although it has become clear that aneurysmal and occlusive arterial disease represent two distinct etiologic entities, it is still unknown whether the two vascular pathologies are prognostically different. We aim to assess the long-term vital prognosis of patients with abdominal aortic aneurysmal disease (AAA) or peripheral artery disease (PAD), focusing on possible differences in survival, prognostic risk profiles and causes of death. Methods: Patients undergoing elective surgery for isolated AAA or PAD between 2003 and 2011 were retrospectively included. Differences in postoperative survival were determined using Kaplan-Meier and Cox regression analysis. Prognostic risk profiles were also established with Cox regression analysis. Results: 429 and 338 patients were included in the AAA and PAD groups, respectively. AAA patients were older (71.7 vs. 63.3 years, p < 0.001), yet overall survival following surgery did not differ (HR: 1.16, 95% CI: 0.87e1.54). Neither was type of vascular disease associated with postoperative cardiovascular nor cancer-related death. However, in comparison with age-and gender-matched general populations, cardiovascular mortality was higher in PAD than AAA patients (48.3% vs. 17.3%). Survival of AAA and PAD patients was negatively affected by age, history of cancer and renal insufficiency. Additional determinants in the PAD group were diabetes and ischemic heart disease. Conclusions: Long-term survival after surgery for PAD and AAA is similar. However, overall life expectancy is significantly worse among PAD patients. The contribution of cardiovascular disease towards mortality in PAD patients warrants more aggressive secondary prevention to reduce cardiovascular mortality and improve longevity.

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Section: Discussionsupporting

confidence: 58%

Peripheral artery disease patients may benefit more from aggressive secondary prevention than aneurysm patients to improve survival

et al. 2016

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“…Moreover, patients with AAA had a more cumulative smoking duration than those without AAA. Meijer et al [8] suggested that there was an association between COPD and AAA that was independent of the smoking status and that COPD was more Using the national data, our preliminary study aimed to detect a possible association between COPD and AAA as there is no such published report in our country. Our results are consistent with those reported in the literature.…”

Section: Discussionmentioning

confidence: 86%

“…Major risk factors for the AAA development include an age of >65 years, smoking, HT, and a presence of a vascular disease [1][2][3]. In recent years, COPD has been accepted to be a predisposing factor for AAA development [4,[6][7][8].…”

Section: Discussionmentioning

confidence: 99%

“…Recent epidemiological studies have shown that considerable chronic comorbidities, mainly cardiovascular diseases, contributed to COPD [4,5]. Although several studies suggest that COPD is associated with AAA development and engenders an additional risk factor for AAA rupture when smaller aneurysms are present, the literature regarding a potential association between the presence of COPD and AAA remains limited [4,[6][7][8]. Furthermore, there is no prevalence study that reflects an epidemiological status of Turkey.…”

Section: Introductionmentioning

confidence: 99%

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What are the Prevalence of Abdominal Aortic Aneurysm in Patients with Chronic Obstructive Pulmonary Diseases and the Characteristics of These Patients?

et al. 2017

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Objective: To determine the prevalence of abdominal aortic aneurysm (AAA) in patients with chronic obstructive pulmonary disease (COPD) and to assess the characteristics of these patients.Materials and Methods: Stable COPD patients (age, >40 years) were included in the study between January 2014 and June 2014. Patients with acute exacerbations and a previous lung resection were excluded. Data regarding demographic characteristics were recorded. The modified Medical Research Council (mMRC) dyspnea scale was used to assess the severity of breathlessness. The COPD Assessment Test (CAT) was performed. Abdominal aortic diameter was measured using abdominal ultrasonography (AUS), and AAA was diagnosed as an aortic diameter of ≥30 mm at the renal artery level.Results: In total, 82 patients were examined. AAA was detected in five (6.1%) patients. Diabetes mellitus, hypertension, and coronary artery disease were present in four patients with AAA. The average mMRC score was 3.2±0.4, and the mean CAT score was 18.4±6.0. Aneurysmal diameter was >50 mm in four patients and 37 mm in one patient. Statistically significant differences were found between patient with AAA and those without AAA with respect to the mean abdominal aortic diameters at the renal artery and iliac artery levels (p=0.012 and 0.002, respectively). Conclusion:Our findings suggest that AAA is associated with COPD, with a prevalence rate of 6.1%. AAA is usually asymptomatic until a clinical status of rupture, which is associated with a higher mortality risk. Early diagnosis of AAA is lifesaving. In COPD patients, AAA might be easily determined using AUS, which is a noninvasive and relatively cheap procedure. Sonuç: Çalışmamızda KOAH hastalarında AAA prevelansı %6,1 bulunmuş olup AAA ile KOAH hastalığının ilişkili olabileceğini düşündürmektedir. AAA yüksek mortalite riski taşıyan ve rüptür gelişimine kadar genellikle asemptomatik seyreden bir hastalıktır. Erken tanı hayat kurtarıcıdır. KOAH hastalarında AAA tanısı non invaziv ve nisbeten ucuz bir yöntem olan AUS ile kolaylıkla konulabilir.

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“…A number of studies [20][21][22][23][24][25][26][27] have suggested that chronic obstructive pulmonary disease (COPD) is independently and positively associated with AAA presence. For instance, the multivariate logistic regression analysis in a recent case-control (271 and 1,387 patients with and without AAA, respectively) study by Song and Park [25] identifi ed COPD as an independent predictor for the risk of AAA (adjusted OR, 1.35; 95% CI, 1.07 to 1.72; P = 0.013).…”

Section: Discussionmentioning

confidence: 99%

The association between body mass index and abdominal aortic aneurysm growth: a systematic review

Takagi

Umemoto

2016

Vasa

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Summary: Diabetes, a state of relative insulin resistance, is negatively associated with both the presence and growth abdominal aortic aneurysms (AAA), which could suggest a protective role of obesity against AAA presence or growth. A recent meta-analysis demonstrated a trend toward a positive, though statistically non-signifi cant, association between body mass index (BMI) and the presence of AAA. With respect to the association between obesity and AAA growth, however, the evidence had been very limited. To determine whether obesity (or BMI) is associated with AAA growth, we reviewed currently available studies with a systematic literature search. Our comprehensive search identifi ed seven eligible studies reporting the association of BMI and AAA growth rates, which included data on a total of 3,768 AAA patients. All seven identifi ed studies demonstrated no association between BMI and AAA growth. Despite a trend toward a positive association between BMI and AAA presence, the reason why BMI is not associated with AAA growth (suggested in the present review) is unclear. A discrepancy between associated comorbidities (coronary artery disease, peripheral artery disease, and chronic obstructive pulmonary disease) and AAA presence and between the same comorbidities and AAA growth, however, could be identifi ed. Further investigations are required to elucidate why BMI is not associated with AAA growth despite the trend for a positive association with AAA presence.

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An Association between Chronic Obstructive Pulmonary Disease and Abdominal Aortic Aneurysm beyond Smoking

Abstract: This study confirms an association between AAA and COPD and shows that this association is independent from smoking. Findings also demonstrate that COPD is under-diagnosed in AAA patients.

Cited by 46 publications

References 25 publications

Peripheral artery disease patients may benefit more from aggressive secondary prevention than aneurysm patients to improve survival

Peripheral artery disease patients may benefit more from aggressive secondary prevention than aneurysm patients to improve survival

What are the Prevalence of Abdominal Aortic Aneurysm in Patients with Chronic Obstructive Pulmonary Diseases and the Characteristics of These Patients?

The association between body mass index and abdominal aortic aneurysm growth: a systematic review

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