Screening cardiovascular patients for aortic aneurysms (SCAN) - high prevalence of abdominal aortic aneurysms in coronary heart disease patients requiring intervention.

Reutersberg, Benedikt; Salvermoser, Michael; Haller, Bernhard; Schäffer, Christoph; Knipfer, Eva; Laugwitz, Karl-Ludwig; Eckstein, Hans-Henning

doi:10.1024/0301-1526/a000881

2020

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Title:: Screening cardiovascular patients for aortic aneurysms (SCAN) - high prevalence of abdominal aortic aneurysms in coronary heart disease patients requiring intervention.
Document type:: Journal Article
Author(s):: Reutersberg, Benedikt; Salvermoser, Michael; Haller, Bernhard; Schäffer, Christoph; Knipfer, Eva; Laugwitz, Karl-Ludwig; Eckstein, Hans-Henning
Abstract:: Background: Since the prevalence of abdominal aortic aneurysms (AAA) in Europe has declined to about 2.5%, general screening programs of elderly men are being called into question. On the other hand, other vascular diseases (e.g. coronary heart disease, CHD) are associated with a higher prevalence of AAA. This might have an impact on future targeted AAA screening programs. This study aimed to reevaluate the current prevalence of AAA in male patients with CHD, in order to assess whether CHD patients should be offered a targeted AAA ultrasound screening program. Patients and methods: The SCAN (Screening Cardiovascular Patients for Aortic Aneurysms) study prospectively evaluated the AAA prevalence in 1000 consecutive male CHD patients (70.1 ± 11.2 years) requiring any coronary intervention at an university hospital. All patients received transverse and longitudinal ultrasound scans of the abdominal aorta. Aortic diameter was assessed using the outer-to-outer measurement-technique. Primary endpoint was the prevalence of AAA. Secondary outcomes included stratification in 1-, 2-, or 3-vessel CHD. Results: AAA was detected in 85 patients (median diameter 38 mm, range 30-80 mm), corresponding to an overall prevalence of 8.5%. AAA prevalence was significantly associated with CHD severity: 5.6% in 1-vessel, 7.1% in 2-vessel, and 10.8% in 3-vessel CHD (P = 0.037). The multivariable analysis showed, that age per 10 years increase (OR 1.5, 95% CI 1.2-1.9, P = 0.001) and hyperlipidemia (OR 2.2, 95% CI 1.3-3.8, P = 0.003) were significantly associated with an AAA. The likelihood to be diagnosed with an AAA was significantly lower in non-smokers (OR 0.24, 95% CI, P < 0.001). Conclusions: This study confirms that CHD requiring any type of coronary intervention is strongly associated with AAA in male patients. AAA prevalence increases with CHD severity. Since the AAA prevalence is still significantly higher than in the general population, targeted ultrasound screening should be considered for all CHD patients.
Journal title abbreviation:: Vasa
Year:: 2020
Journal volume:: 49
Journal issue:: 5
Pages contribution:: 375-381
Fulltext / DOI:: doi:10.1024/0301-1526/a000881
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/32631140
Print-ISSN:: 0301-1526
TUM Institution:: Fachgebiet Gefäßchirurgie (Prof. Eckstein); I. Medizinische Klinik und Poliklinik (Kardiologie); Institut für Medizinische Statistik und Epidemiologie
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