Coronary Artery Disease as a Relevant Risk Factor in Screening of Abdominal Aortic Ectasia and Aneurysm

Koshty, Ahmed; Bork, M.; Böning, Andreas; Gündüz, Dursun; Pleger, Sebastian Paul

doi:10.1055/s-0038-1676336

Cited by 7 publications

(4 citation statements)

References 32 publications

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“…Several studies have reported smoking as a risk factor for AAA expansion. 4,19) CAD was reported to be a risk factor for AAA by many studies 12,13,20,21) but was found to be not associated with AAA in a meta-analysis 22) ; therefore, there is room for further discussion on CAD. Similarly, PAD as a risk factor for AAA remains a topic of debate, and future accumulation of data is desired.…”

Section: Discussionmentioning

confidence: 99%

Opportunistic Ultrasound Screening for Abdominal Aortic Aneurysm

Funamizu,

Goto,

Oda

et al. 2024

Annals of Vascular Diseases

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Objective: In patients with abdominal aortic aneurysm (AAA), early detection and optimal elective treatment before rupture are desirable. In the absence of an established public screening system, opportunistic screening during ultrasound examination for another purpose might be efficacious. The aim of this study was to evaluate the efficacy of opportunistic screening for AAA. Methods: This prospective multicenter observational study enrolled patients who were scheduled to undergo ultrasound for reasons other than AAA. After the ultrasound for the original purpose, evaluation of the abdominal aorta was added. If the abdominal aorta was clear enough for measurement, its diameter and shape were recorded. Furthermore, information on comorbidities was collected for each patient. Results: A total of 10325 patients (echocardiography: 6150; abdominal ultrasound: 4162) from 16 institutions were enrolled. The abdominal aorta was well visualized in 92.9% of patients who underwent echocardiography. Among 9791 patients, AAA was diagnosed in 122 (1.3%) (107 fusiform and 15 saccular), with a diameter range of 30-63 mm. The diagnostic rate increased with age. On multivariate analysis, older age, male sex, coronary artery disease, peripheral arterial disease, and smoking habituation were the risk factors for AAA. Conclusion: Opportunistic screening for AAA was efficacious.

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Section: Discussionmentioning

confidence: 99%

Opportunistic Ultrasound Screening for Abdominal Aortic Aneurysm

Funamizu,

Goto,

Oda

et al. 2024

Annals of Vascular Diseases

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“…In addition to atherosclerosis, a close relationship has been found with some vasculitis and autoimmune diseases [21]. It has also been found to be associated with causes such as familial hypercholesterolemia, drug-eluting stent, abdominal aortic aneurysm, and inflammation [22][23][24][25]. Although CAE is considered to be an atherosclerotic process, it is interestingly less common in diabetes patients, which is considered a major atherosclerosis risk factor [26].…”

Section: Dicussionmentioning

confidence: 99%

The Impact of C-Peptide and Diabetes Mellitus on Coronary Ectasia and Effect of Coronary Ectasia and C-Peptide on Long-Term Outcomes: A Retrospective Cohort Study

Toprak

Kaplangöray

Palice

2022

International Journal of Clinical Practice

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Background. Coronary artery ectasia (CAE) is an entity frequently associated with atherosclerotic coronary artery disease (CAD) in clinical practice. Although it has common risk factors with atherosclerotic CAD in its development, the pathophysiology of CAE is not fully known and it is not seen in every CAD suggesting that different determinants may play a pivotal role in the development of CAD. This study aimed to reveal the impact of C-peptide and diabetes mellitus (DM) on CAE and the effect of C-peptide and coronary ectasia on long-term outcomes in patients who underwent coronary angiography. Methods. A total of 6611 patients who underwent coronary angiography were followed up retrospectively, and their major adverse cardiovascular event (MACE) status of an average of sixty months was recorded. According to their angiographic features, the patients were divided into two groups those with and without CAE. MACE development was accepted as the primary endpoint. Results. A total of 552 patients had CAE and MACE developed in 573 patients. Patients with CAE and higher C-peptide levels (Q4 + Q3) showed higher rates of MACE as compared to those without CAE and lower C-peptide levels (Q1 + Q2) (20.8% vs 7.6%; 70.1% vs 29.1%; p < 0.001 , for both of them). In multivariate regression analysis, high C-peptide levels were determined as an independent risk factor for CAE (OR 2.417; 95% CI 2.212–2.641; p < 0.001 ). The Kaplan–Meier cumulative survival curves showed that the risks for MACE increased as the C-peptide levels increased. The Cox regression analysis for 5-years MACE related to the plasma C-peptide levels and presence of CAE, C-peptide, and CAE were found to be independent predictors of MACE (HR = 1.255, 95% CI: 1.164–1.336, p < 0.001 and HR = 1.012, 95% CI: 1.002–1.023, p = 0.026 , respectively). Conclusion. Our study revealed that a high C-peptide level is an independent risk factor for CAE and that CAE and C-peptide are independent predictors for the development of MACE.

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“…23 Also, 5.4% of CAD patients had AAA in a large cohort study. 36 CAD patients require cardiac rehabilitation (CR) to improve life expectancy, 37 but when CAD patients have AAA, doctors are hesitant to prescribe CR for fear that BP elevation during exercise may cause AAA expansion or rupture. Here, we should identify the safety zone of exercise intensity for AAA patients, and examine whether CAD patients with AAA could obtain benefit from CR.…”

Section: High Frequency Of Cad In Aaa Patientsmentioning

confidence: 99%

Comprehensive Cardiac Rehabilitation as a Therapeutic Strategy for Abdominal Aortic Aneurysm

2019

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stenosis. 11 Among them, inflammatory cells and cytokines play an important role in AAA occurrence and expansion. 12-14 Consistently, inhibition of tumor necrosis factor (TNF)-α, the complement system and peroxisome proliferator-activated receptor γ successfully prevented AAA formation and expansion in mouse AAA models. 15 In contrast, anti-transforming growth factor-β (anti-TGF-β) antibody injection induced AAA rupture in an angiotensin II-stimulated AAA model, 16 indicating that upregulated TGF-β plays a protective role against AAA progression and rupture. 16,17 Taken together, at least in animal models, the mechanism underlying AAA expansion is not similar to that underlying the occurrence of AAA. Risk Factors for AAA Occurrence, Expansion, and Rupture in Humans Consistent with the aforedescribed experimental findings, the risk profiles of occurrence, expansion, and rupture of AAA are different from one another in humans. Except for AAA caused by infection, trauma, or Marfan syndrome, AAA occurrence is more prevalent in aged patients, male subjects, smokers, and those who have chronic obstructive pulmonary disease, hypertension, and low high-density lipoprotein cholesterol. 18 Many cohort studies identified smoking as the strongest risk factor for AAA formation. 19 A cohort study in Sweden suggested that

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Coronary Artery Disease as a Relevant Risk Factor in Screening of Abdominal Aortic Ectasia and Aneurysm

Cited by 7 publications

References 32 publications

Opportunistic Ultrasound Screening for Abdominal Aortic Aneurysm

Opportunistic Ultrasound Screening for Abdominal Aortic Aneurysm

The Impact of C-Peptide and Diabetes Mellitus on Coronary Ectasia and Effect of Coronary Ectasia and C-Peptide on Long-Term Outcomes: A Retrospective Cohort Study

Comprehensive Cardiac Rehabilitation as a Therapeutic Strategy for Abdominal Aortic Aneurysm

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