Prevalence of abdominal aortic aneurysm and associated lower extremity artery aneurysm in men hospitalized for suspected or known cardiopulmonary disease
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Medientyp:
E-Artikel
Titel:
Prevalence of abdominal aortic aneurysm and associated lower extremity artery aneurysm in men hospitalized for suspected or known cardiopulmonary disease
Beschreibung:
<jats:title>Abstract</jats:title><jats:sec>
<jats:title>Background</jats:title>
<jats:p>AAA is a disease affecting predominantly male patients ≥65 years and its dreaded complications such as rupture led to population-based screening programs as preventive measure. Nonetheless, the supposed prevalence may have been overestimated, so that targeted screening of high risk populations may be more effective.</jats:p>
<jats:p>This study was performed to evaluate the prevalence of abdominal aortic aneurysm (AAA) of an inpatient high-risk cohort and to estimate the co-prevalence of lower extremity arterial aneurysms.</jats:p>
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<jats:title>Methods</jats:title>
<jats:p>Participants<jats:bold>:</jats:bold> 566 male inpatients, ≥ 65 years of age, hospitalized for suspected or known cardiopulmonary disease.</jats:p>
<jats:p>Primary and secondary outcome measures: Maximal infrarenal aortic diameters using abdominal ultrasound (leading edge to leading edge method). Upon detection of an AAA (diameter ≥ 30 mm), the lower extremity arteries were examined with regard to associated aneurysms.</jats:p>
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<jats:title>Results</jats:title>
<jats:p>In 40 of 566 patients (7.1%) AAAs were detectable. Fourteen patients (2.5%) had a first diagnosis of AAA, none of which was large (> 55 mm), the remaining 26 patients were either already diagnosed (14 patients, 2.5%) or previously repaired (12 patients, 2.1%).</jats:p>
<jats:p>The three most common main diagnoses at discharge were acute coronary syndrome (43.3%), congestive heart failure (32.2%), and chronic obstructive pulmonary disease (12%). The cohort showed a distinct cardiovascular risk profile comprising arterial hypertension (82.9%), diabetes mellitus (44.4%), and a history of smoking (57.6%).</jats:p>
<jats:p>In multivariate analysis, three-vessel coronary artery disease (Odds ratio (OR): 4.5, 95% confidence interval (CI): 2.3–8.9, <jats:italic>p</jats:italic> < 0.0001) and history of smoking (OR: 3.7, CI: 1.6–8.6, <jats:italic>p</jats:italic> < 0.01) were positively associated with AAA, while diabetes mellitus (OR: 0.5, CI: 0.2–0.9, <jats:italic>p</jats:italic> = 0.0295) showed a negative association with AAA.</jats:p>
<jats:p>Among the subjects with AAA, we found two large iliac and two large popliteal aneurysms.</jats:p>
</jats:sec><jats:sec>
<jats:title>Conclusion</jats:title>
<jats:p>Ultrasound screening in male inpatients, hospitalized for suspected or known cardiopulmonary disease, revealed a high AAA prevalence in comparison to the present epidemiological screening programs. There was a moderate proportion of newly-screen detected AAA and additional screening of the lower extremity arteries yielded some associated aneurysms with indication for possible intervention.</jats:p>
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