Beomseok Suh1, Yong Sub Song2, Dong Wook Shin3, Jiyeon Lim2, Hyunbin Kim4, Sa-Hong Min5, Seung-Pyo Lee6, Eun-Ah Park2, Whal Lee2, Hyejin Lee7, Jin Ho Park7, BeLong Cho7. 1. Lunit Inc, Seoul, Republic of Korea. 2. Department of Radiology and Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Republic of Korea. 3. Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Seoul, Republic of Korea. Electronic address: dwshin.md@gmail.com. 4. Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea. 5. Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea. 6. Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea. 7. Department of Family Medicine & Health Promotion Center, Seoul National University Hospital, Seoul, Republic of Korea.
Abstract
BACKGROUND: Atherosclerotic lesions in the abdominal aorta or its major branches are often incidentally detected on abdominal CT. However, clinical implications and optimal subsequent management are mostly left undetermined. METHODS: Consecutive, asymptomatic adults (age≥30) who underwent both abdominal CT and coronary computed tomography angiography as part of a self-referred health check-up were investigated (n = 1494). RESULTS: Adjusted for cardiovascular risk factors, abdominal atherosclerotic lesions with stenosis<25% were associated with significant coronary stenosis, especially in the abdominal aorta (adjusted odds ratio [aOR] 3.37, 95% confidence interval [CI] 0.99-11.45) and any common iliac artery (aOR 2.99, 95% CI 1.43-6.26). The association was higher in atherosclerotic lesions with stenosis≥25%, respectively (aOR 16.39, 95% CI 4.00-67.11; aOR 7.32, 95% CI 2.84-18.86). Furthermore, any major abdominal artery stenosis added predictive value to significant coronary stenosis (area under the receiver operating curve: 0.7598 vs. 0.8019, P < 0.001). The extent of arterial territory involvement was associated with the presence of significant coronary stenoses (P for trend <0.001). CONCLUSION: Stenotic atherosclerotic lesions in the abdominal aorta or its major branches incidentally detected on abdominal CT are relatively prevalent and carry high risk for asymptomatic coronary arterial disease.
BACKGROUND:Atherosclerotic lesions in the abdominal aorta or its major branches are often incidentally detected on abdominal CT. However, clinical implications and optimal subsequent management are mostly left undetermined. METHODS: Consecutive, asymptomatic adults (age≥30) who underwent both abdominal CT and coronary computed tomography angiography as part of a self-referred health check-up were investigated (n = 1494). RESULTS: Adjusted for cardiovascular risk factors, abdominal atherosclerotic lesions with stenosis<25% were associated with significant coronary stenosis, especially in the abdominal aorta (adjusted odds ratio [aOR] 3.37, 95% confidence interval [CI] 0.99-11.45) and any common iliac artery (aOR 2.99, 95% CI 1.43-6.26). The association was higher in atherosclerotic lesions with stenosis≥25%, respectively (aOR 16.39, 95% CI 4.00-67.11; aOR 7.32, 95% CI 2.84-18.86). Furthermore, any major abdominal artery stenosis added predictive value to significant coronary stenosis (area under the receiver operating curve: 0.7598 vs. 0.8019, P < 0.001). The extent of arterial territory involvement was associated with the presence of significant coronary stenoses (P for trend <0.001). CONCLUSION:Stenotic atherosclerotic lesions in the abdominal aorta or its major branches incidentally detected on abdominal CT are relatively prevalent and carry high risk for asymptomatic coronary arterial disease.
Authors: Martin Necas; Matt Adams; Orlaith Brennan; Nicole Curtis; Rachel Heslop; Emma Woodrow-Smith Journal: Australas J Ultrasound Med Date: 2020-05-27