title: Prevention of rupture of abdominal aortic aneurysm.
abstract: OBJECTIVE
  Two thirds of patients with an abdominal aortic aneurysm (AAA) have relevant coronary artery disease (CAD). AAAs are prevalent in up to 16% of smokers with CAD. General screening of AAA is controversial. Aim was to assess the potential of finding AAA prior to rupture among patients with known CAD. Main endpoint was whether AAA could have been found during follow-up by sonography or at other time of cardiovascular evaluation.
  
  
  METHODS
  Retrospective study. 213 consecutive, formerly unknown emergently operated AAAs, treated emergently for symptoms (n = 91) or rupture (n = 122) (rAAA) between January 1998 and June 2005. Patient charts were analysed and primary care physicians contacted.
  
  
  RESULTS
  At presentation, mean age was 71 (+/-9) years, twenty (9%) were female. AAA had a mean diameter of 7.6 cm. Two thirds (143) were clinically obese (BMI 27 +/-5). 137 (64%) were active smokers, 32 (15%) had diabetes, 151 (71%) were hypertensive, and 80 (38%) received statin treatment. CAD had been diagnosed in 95 (45%) 9 years earlier and followed up. Thirty-five (16%) had had myocardial infarction. Echocardiography had been performed in 52 (24%). Thirty day mortality after open surgery was 25 (21%).
  
  
  CONCLUSIONS
  All patients with rAAA had been seen by a GP or cardiologist within a year prior to presentation. The cost effectiveness of selective AAA screening should be evaluated in a larger study.
authors.affiliation: University of the West Indies, Queen Elizabeth Hospital, Bridgetown, Barbados. Hannu.savolainen@cavehill.uwi.edu
authors.forename: H
authors.initials: H
authors.lastname: Savolainen
authors.forename: J
authors.initials: J
authors.lastname: Novak
authors.forename: F
authors.initials: F
authors.lastname: Dick
authors.forename: M K
authors.initials: MK
authors.lastname: Widmer
authors.forename: T
authors.initials: T
authors.lastname: Carrel
authors.forename: J
authors.initials: J
authors.lastname: Schmidli
authors.forename: B
authors.initials: B
authors.lastname: Meier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D001019:Aortic Rupture / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D002309:Cardiology / Q000458:organization & administration; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D058006:General Practice / Q000458:organization & administration; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000458:organization & administration; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome