Kevin C Chun1, Kai Y Teng1, LeAnn A Chavez2, Elyse N Van Spyk1, Kiana M Samadzadeh1, John G Carson3, Eugene S Lee4. 1. Department of Surgery, Sacramento Veterans Affairs Medical Center, Mather, CA. 2. Department of Surgery, University of California-Davis, Sacramento, CA. 3. Department of Surgery, Sacramento Veterans Affairs Medical Center, Mather, CA; Department of Surgery, University of California-Davis, Sacramento, CA. 4. Department of Surgery, Sacramento Veterans Affairs Medical Center, Mather, CA; Department of Surgery, University of California-Davis, Sacramento, CA. Electronic address: Eugenes.lee@ucdmc.ucdavis.edu.
Abstract
BACKGROUND: An active abdominal aortic aneurysm (AAA) screening program at a regional Veterans Affairs (VA) health system identifies patients at risk for AAA. The purpose of this study is to evaluate unique risk factors associated with the AAA diagnosis upon AAA screening examination to identify the most at risk patients for AAA. METHODS: Data were extracted from a regional VA health care system to identify patients who underwent AAA screening within a 3-year period. An aortic diameter ≥3.0 cm was defined as an AAA. Patient risk factors included age, body mass index, total cholesterol, estimated glomerular filtration rate (eGFR), statin use, and active smoking status; the presence of hypertension, diabetes, coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), or peripheral vascular disease (PVD) was also evaluated. Risk factors were compared in a multivariate analysis between patients with AAA and patients with a normal aorta. RESULTS: A total of 6,142 patients (mean ± SD age: 72.7 ± 5.3 years) were screened for AAA between January 2007 and December 2009. A total of 469 patients (7.6%) with AAA were identified. The following risk factors were significantly associated with a diagnosis of AAA: age >75 years (39.6% vs. 28.9%; P < 0.001), prevalence of CAD (43.1% vs. 28.5%; P < 0.001), COPD (26% vs. 11.4%; P < 0.001), PVD (37.3% vs. 7.7%; P < 0.001), eGFR <60 mL/min (36.7% vs. 24.3%; P < 0.001), and current smoking (23.2% vs. 15.3%; P < 0.001). The risk factors significantly associated with normal aortic size were the presence of diabetes (18.6% vs. 27.4%; P < 0.001) and total cholesterol ≥200 mg/dL (10.4% vs. 15%; P = 0.04). CONCLUSIONS: The diagnosis of AAA in a large screening study is typically identified in patients who are at high risk for cardiovascular disease. The presence of diabetes is a major cardiovascular risk factor that is more associated with normal aorta when compared to patients with the AAA diagnosis. Total cholesterol ≥200 mg/dL was associated with decreased AAA risk, and renal insufficiency was associated with increased AAA risk. Published by Elsevier Inc.
BACKGROUND: An active abdominal aortic aneurysm (AAA) screening program at a regional Veterans Affairs (VA) health system identifies patients at risk for AAA. The purpose of this study is to evaluate unique risk factors associated with the AAA diagnosis upon AAA screening examination to identify the most at risk patients for AAA. METHODS: Data were extracted from a regional VA health care system to identify patients who underwent AAA screening within a 3-year period. An aortic diameter ≥3.0 cm was defined as an AAA. Patient risk factors included age, body mass index, total cholesterol, estimated glomerular filtration rate (eGFR), statin use, and active smoking status; the presence of hypertension, diabetes, coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), or peripheral vascular disease (PVD) was also evaluated. Risk factors were compared in a multivariate analysis between patients with AAA and patients with a normal aorta. RESULTS: A total of 6,142 patients (mean ± SD age: 72.7 ± 5.3 years) were screened for AAA between January 2007 and December 2009. A total of 469 patients (7.6%) with AAA were identified. The following risk factors were significantly associated with a diagnosis of AAA: age >75 years (39.6% vs. 28.9%; P < 0.001), prevalence of CAD (43.1% vs. 28.5%; P < 0.001), COPD (26% vs. 11.4%; P < 0.001), PVD (37.3% vs. 7.7%; P < 0.001), eGFR <60 mL/min (36.7% vs. 24.3%; P < 0.001), and current smoking (23.2% vs. 15.3%; P < 0.001). The risk factors significantly associated with normal aortic size were the presence of diabetes (18.6% vs. 27.4%; P < 0.001) and total cholesterol ≥200 mg/dL (10.4% vs. 15%; P = 0.04). CONCLUSIONS: The diagnosis of AAA in a large screening study is typically identified in patients who are at high risk for cardiovascular disease. The presence of diabetes is a major cardiovascular risk factor that is more associated with normal aorta when compared to patients with the AAA diagnosis. Total cholesterol ≥200 mg/dL was associated with decreased AAA risk, and renal insufficiency was associated with increased AAA risk. Published by Elsevier Inc.
Authors: Kevin C Chun; Richard C Anderson; Hunter C Smothers; Kanika Sood; Zachary T Irwin; Machelle D Wilson; Eugene S Lee Journal: J Vasc Surg Date: 2019-11-07 Impact factor: 4.268
Authors: Kunihiro Matsushita; Lucia Kwak; Shoshana H Ballew; Morgan E Grams; Elizabeth Selvin; Aaron R Folsom; Josef Coresh; Weihong Tang Journal: Atherosclerosis Date: 2018-09-01 Impact factor: 5.162
Authors: Jing Liu; Hisashi Sawada; Deborah A Howatt; Jessica J Moorleghen; Olga Vsevolozhskaya; Alan Daugherty; Hong S Lu Journal: Ann Vasc Med Res Date: 2020-01-13