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Abdominal Aortic Aneurysms and Coronary Artery Disease in a Small Country with High Cardiovascular Burden

DOI: 10.1155/2014/825461

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Abstract:

We aimed to evaluate the frequency, clinical profiles and outcomes of abdominal aortic aneurysms (AAA), and their association with coronary artery disease (CAD) in a small country with high cardiovascular burden. Methods. Data were collected for all adult patients who underwent abdominal computed tomography scans at Hamad General Hospital in Qatar between 2004 and 2008. Results. Out of 13,115 screened patients for various reasons, 61 patients (0.5%) had abdominal aneurysms. The majority of AAA patients were male (82%) with a mean age of 67 ± 12 years. The incidence of AAA substantially increased with age reaching up to 5% in patients >80?yrs. Hypertension was the most prevalent risk factor for AAA followed by smoking, dyslipidemia, renal impairment, and diabetes mellitus. CAD and peripheral arterial disease (PAD) were observed in 36% and 13% of AAA patients, respectively. There were no significant correlations between CAD or PAD and site and size of AAA. Conclusion. This is the largest study in our region that describes the epidemiology of AAA with concomitant CAD. As the mortality rate is quite high in this high risk population, routine screening for AAA in CAD patients and vice versa needs further studies for proper risk stratification. 1. Introduction Screening programs for abdominal aortic aneurysm (AAA) are lacking in the developing countries. Global data reported that the prevalence of AAA varies in men (1.3%–8.9%) and women (11%–2.2%) [1]. The rising incidence of AAA is related mainly to the increase in age, physician awareness with clinical high index of suspicion, and the use of advanced diagnostic modalities. As AAA is a silent process, it may present only with aneurysmal rupture in most of cases. It was believed for a long time that atherosclerosis is the main pathogenesis of AAA. However, this speculation has raised a question that whether atherosclerosis is a “bystander” condition or an active factor for the initiation or acceleration of AAA [1, 2]. In a systematic review, Elkalioubie et al. evaluated 17 published studies between 1991 and 2010 [1]. The authors found that the frequency of AAA among coronary artery disease patients ranged between 0.48% and 18.2% [1]. As advanced age is a potential risk factor for both coronary artery disease and AAA, five studies specifically recruited patients who were above 60 years. Salem et al. [3] reported a lower prevalence of AAA among men of Asian origin (China and Iran), indicating that certain ethnic groups experience a disproportionately smaller burden of AAA. Notably, the prevalence of AAA in

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