title: Preoperative Cardiovascular Assessment and Late Cardiovascular Events after Elective Abdominal Aortic Aneurysm Repair.
abstract: BACKGROUND
  Cardiovascular evaluation is performed before elective repair of abdominal aortic aneurysm (AAA) because of the high prevalence of cardiovascular disease. We investigated the association between preoperative cardiovascular evaluation and the incidence of late cardiovascular events after AAA repair.
  
  
  METHODS
  We retrospectively analyzed 438 patients who underwent elective repair of AAA. Echocardiography, serial coronary assessment using functional myocardial scanning or coronary angiography, and carotid ultrasound scanning were performed preoperatively. Coronary revascularization after serial coronary assessment was performed preoperatively or simultaneously in 21 patients, and 54 patients had a remote history of coronary revascularization.
  
  
  RESULTS
  The 5-year survival rate, incidence rate of cardiovascular events (myocardial infarction or stroke), and incidence rate of major adverse cardiovascular events (MACE; cardiovascular death or cardiovascular events) were 86.0%, 5.7%, and 11.5%, respectively. Carotid stenosis was associated with these long-term outcomes, and hypokinesis, determined by echocardiography, increased the incidence of cardiovascular events and MACE. Serial coronary assessment findings and history of previous or preoperative coronary revascularization were not associated with these long-term outcomes.
  
  
  CONCLUSIONS
  Preoperative cardiovascular evaluation and treatment are beneficial for reducing not only perioperative risk but also late cardiovascular events.
authors.affiliation: Department of Vascular Surgery, Kyushu Medical Center, Fukuoka, Japan. Electronic address: onohara@kyumed.jp.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Onohara
authors.affiliation: Department of Vascular Surgery, Kyushu Medical Center, Fukuoka, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Inoue
authors.affiliation: Department of Vascular Surgery, Kyushu Medical Center, Fukuoka, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Furuyama
authors.affiliation: Department of Vascular Surgery, Kyushu Medical Center, Fukuoka, Japan.
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Ohno
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000401:mortality / Q000601:surgery*; D017558:Elective Surgical Procedures; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology*; D011300:Preoperative Care; D012189:Retrospective Studies; D020521:Stroke / Q000453:epidemiology*; D015996:Survival Rate