Prevalence and risk factors for combined coronary artery disease and aortic aneurysm.
OBJECTIVE
To evaluate CAD prevalence in patients with aortic aneurysm, as well as differences related to aneurysm topographies. To describe the primary risk factors for CAD related to this association and their occasional differences according to AA topographies.


METHODS
This was an open, prospective, nonrandomized study that evaluated 95 patients (66 men and 33 women, mean age 63 +/- 11.8). All patients, asymptomatic for CAD, had undergone aortic CT and coronary angiography. According to the AA topography, they were classified into three groups: 1) patients with thoracic aortic aneurysm (TAA); 2) thoracoabdominal aortic aneurysm (TAAA); and 3) abdominal aortic aneurysm (AAA). A database was created to store information from clinical data and complementary examinations. Statistical analysis was performed using the Students t test or analysis of variance (ANOVA) for continuous variables and chi-square test for categorical variables. P values < 0.05 were considered statistically significant.


RESULTS
CAD prevalence was 63.1%, and AAA was more prevalent than TAA and TAAA (76% vs. 70% vs. 30%, p = 0.001). The comparative analysis of CAD risk factors based on the aortic aneurysm topography revealed that smoking and dyslipidemia were more prevalent among AAA patients (74.5% vs. 42.3% vs. 60%, p = 0.01 and (54.2% vs. 19.9% vs. 60%, p = 0.007, respectively). As for coronary lesion severity in the population of AA patients, 12 (20%) had at least one lesion > or = 70% and 19 (31.6%), > or = 50%. Fifteen patients (25%) had single-vessel disease, 11 (18%) had two-vessel disease, and 34 (57%) had three-vessel disease.


CONCLUSIONS
Asymptomatic CAD is highly prevalent in AA patients, particularly among those with AAA. Study results suggest the need for diagnostic stratification for CAD in patients with AA, especially those with AAA.
Ferro
Carlos Romério Costa
CR
Hospital do Coração, Associação do Sanatório Sírio, São Paulo, SP, Brazil.
de Oliveira
Dinaldo Cavalcanti
DC
Guerra
Fábio de Freitas Guimarães
Fde F
de Lucena
Alexandre Jorge
AJ
Nunes
Fabiana Piech
FP
Ortiz
Sergio Tranchesi
ST
Egito
Enilton Sergio Tabosa
ES
de Sousa
Luis Carlos Bento
LC
Jatene
Adib Domingos
AD
Piegas
Leopoldo Soares
LS
D000328:Adult; D001014:Aortic Aneurysm / Q000150:complications*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed