Prevalence of abdominal aortic aneurysm and large infrarenal aorta in patients with acute coronary syndrome and proven coronary stenosis: a prospective monocenter study

Abstract

Background: Little is known about the prevalence of abdominal aortic aneurysm (AAA) in patients with coronary heart disease. The aims of this prospective study were to evaluate the prevalence of AAA and of large abdominal aorta in patients hospitalized for acute coronary syndrome and coronary stenosis of 50% or greater.

Methods: AAA ultrasound screening was prospectively performed in 306 patients after they gave informed consent. AAA and large abdominal aorta were defined by maximum anteroposterior diameter of 30 mm or greater and of 20 to 29 mm, respectively. Patient characteristics were prospectively collected. Univariate and multivariate analyses were used to identify risk factors for AAA and large abdominal aorta. A p value <0.05 was considered statistically significant.

Results: AAAs were diagnosed in 20 patients (6.6%). Mean diameter was 33 +/- 3.7 mm, and median diameter [min--max] was 31 mm [30 - 45 mm]. All except one AAA were between 30 and 40 mm. No AAAs were detected in patients younger than 50 years. Prevalence reached 7.7% in patients older than 50 years. Using stepwise logistic regression analysis, age (odds ratio [OR] 1.04. 95% confidence [CI] 1.00-1.09 per year of age, p = 0.06) and previous coronary events (OR 2.44, 95% CI 0.96-6.25, p = 0.06) showed a borderline significant association with AAA. Large infrarenal aortic diameter was observed in 32% of patients. Age (OR 1.03, 95% CI 1.02-1.05 per year of age, p < 0.0001), male gender (OR 16.7, 95% CI 6.25-50.0, p < 0.0001), and overweight (OR 2.0, 95% CI 1.2-3.4, p = 0.01) showed a significant independent association with large aorta.

Conclusion: AAA and large infrarenal aorta prevalence seems high in patients with acute coronary syndrome and proven coronary stenosis of 50% or greater. Previous coronary events and older age might be associated with higher risk of AAA, and age, male gender, and obesity are significantly associated with large infrarenal aorta. If these results are confirmed in larger studies, further guidelines concerning AAA screening in this well-defined population should be considered.