title: Prevalence of previously undiagnosed abdominal aortic aneurysms in the area of Como: the ComoCuore "looking for AAA" ultrasonography screening.
abstract: The prognosis for abdominal aortic aneurysm (AAA) rupture is poor. Long-term follow-up of population-based randomized trials has demonstrated that ultrasound (US) screening for abdominal aortic aneurysms (AAAs) measuring 3 cm or greater decreases AAA-related mortality rates and is cost-effective. We though to prospectively perform during a 26-month period a limited US examination of the infrarenal aorta in volunteers of both gender aged 60-85 years without history of AAA living in the area of Como, Italy. From September 2010 to November 2013 ComoCuore, a no-profit nongovernmental association, enrolled 1555 people (aged 68.8 ± 6.8 years; 48.6 % males). Clinical data and a US imaging of the aorta were collected for each participant. AAA was found in 22 volunteers (1.4 %) mainly males (2.5 % in males vs. 0.4 % in females p = 0.005). Overall, the prevalence of cardiovascular risk factors was higher in patients with vs. without AAA (mean 2.9 ± 3.0 vs. 1.4 ± 1.0 respectively, p < 0.0001). Independent predictors of AAA on multivariate analysis were age (OR 1.14, 1.06-1.22; p < 0.0001), male gender (OR 8.23, 1.79-37.91; p = 0.007), and both current (OR 4.98, 1.57-15.79; p = 0.007) and previous smoking (OR 2.76, 1.12-8.94; p = 0.03). Our study confirms the feasibility of one time US screening for AAA in a large cohort of asymptomatic people. Independent predictors of AAA were male sex, older age and a history of smoking. Accordingly to recent data the prevalence of AAA seems to be declining, maybe due to a reduction of smoking in Italy.
authors.affiliation: Unità Operativa di Cardiologia, Ospedale Generale Valduce, Via Dante 11, 22100, Como, Italy. gcorr@iol.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corrado
authors.affiliation: Unità Operativa di Cardiologia, Ospedale Generale Valduce, Via Dante 11, 22100, Como, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Durante
authors.affiliation: Department of Radiology, INRCA, Casatenuovo, Lecco, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Genchi
authors.affiliation: Department of Radiology, Beata Vergine Hospital, Bellinzona, Switzerland.
authors.forename: Loris
authors.initials: L
authors.lastname: Trabattoni
authors.affiliation: Department of Neurology, Ospedale Civile, Vimercate, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Beretta
authors.affiliation: Como Cuore Onlus, Como, Italy.
authors.forename: Enza
authors.initials: E
authors.lastname: Rovelli
authors.affiliation: Unità Operativa di Cardiologia, Ospedale Generale Valduce, Via Dante 11, 22100, Como, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Foglia-Manzillo
authors.affiliation: Como Cuore Onlus, Como, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ferrari
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000453:epidemiology; D058070:Asymptomatic Diseases; D016009:Chi-Square Distribution; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D013997:Time Factors; D014463:Ultrasonography / Q000379:methods*
keywords: Abdominal aortic aneurysm; Screening; Ultrasound