title: Inverse association between the existence of coronary artery disease and progression of abdominal aortic aneurysm.
abstract: OBJECTIVE
  A strong degree of co-existence between coronary artery disease (CAD) and abdominal aortic aneurysm (AAA) is widely acknowledged, however, it remains to be elucidated whether the existence of CAD is associated with an accelerated expansion rate of AAA. Also, the relationship between preoperative CAD and postoperative major adverse cardiovascular events (MACE) has not been examined in Japanese patients. The aim of this study was to investigate the deleterious effects of CAD on the progression of AAA and the onset of postoperative MACE after elective AAA repair.
  
  
  RESULTS
  A retrospective cohort study of 665 consecutive Japanese patients who underwent elective surgical repair for infrarenal AAA at 2 high-volume Tokyo hospitals from 2003 through 2010 was performed. Preoperative CAD was shown to be a significant determinant of postoperative MACE (HR 2.29; 95%CI, 1.12-4.66; p=0.02). In the analysis of 510 patients for whom there were at least 2 follow-up CT scans of the size of their AAA before repair, the existence of CAD was shown to be inversely associated with the accelerated expansion rate of AAA.
  
  
  CONCLUSIONS
  This study on the patients undergone elective repair for infrarenal AAA identified an inverse association between the existence of CAD and progression of AAA as well as the significant impact of preoperative CAD on the occurrence of postoperative MACE after elective AAA repair.
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Nakayama
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Morita
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Miyata
authors.forename: Jiro
authors.initials: J
authors.lastname: Ando
authors.forename: Hideo
authors.initials: H
authors.lastname: Fujita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohtsu
authors.forename: Takafumi
authors.initials: T
authors.lastname: Akai
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Hoshina
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Nagayama
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Takanashi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Sumiyoshi
authors.forename: Ryozo
authors.initials: R
authors.lastname: Nagai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000401:mortality / Q000601:surgery; D044466:Asian People; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000150:complications* / Q000601:surgery; D018450:Disease Progression; D017558:Elective Surgical Procedures / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014656:Vascular Surgical Procedures / Q000401:mortality