open access

Vol 27, No 4 (2020)
Original articles — Clinical cardiology
Published online: 2018-09-07
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Coexistence and management of abdominal aortic aneurysm and coronary artery disease

Mateusz K. Hołda, Paweł Iwaszczuk, Karolina Wszołek, Jakub Chmiel, Andrzej Brzychczy, Mariusz Trystuła, Marcin Misztal
DOI: 10.5603/CJ.a2018.0101
·
Pubmed: 30234902
·
Cardiol J 2020;27(4):384-393.

open access

Vol 27, No 4 (2020)
Original articles — Clinical cardiology
Published online: 2018-09-07

Abstract

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.

Abstract

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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Keywords

abdominal aortic aneurysm, coronary artery aneurysm, coronary arteriography, coronary artery disease

About this article
Title

Coexistence and management of abdominal aortic aneurysm and coronary artery disease

Journal

Cardiology Journal

Issue

Vol 27, No 4 (2020)

Pages

384-393

Published online

2018-09-07

DOI

10.5603/CJ.a2018.0101

Pubmed

30234902

Bibliographic record

Cardiol J 2020;27(4):384-393.

Keywords

abdominal aortic aneurysm
coronary artery aneurysm
coronary arteriography
coronary artery disease

Authors

Mateusz K. Hołda
Paweł Iwaszczuk
Karolina Wszołek
Jakub Chmiel
Andrzej Brzychczy
Mariusz Trystuła
Marcin Misztal

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