Clinical Outcomes of Aortic Aneurysm Patients with and without Accompanying Coronary Artery Disease
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BACKGROUND: This study investigates the prevalence of coronary artery disease and adverse cardiac outcomes in patients with Aortic Aneurysms. METHOD: The study analyzed data from 501 Veterans Affairs (VA) out-patients diagnosed with AA between October 1992 and April 2013. AA diagnosis was defined by computed tomography or ultrasound as greater than 1.5 times the normal aortic diameter. CAD was defined using a diagnosis from medical records and severe CAD as those revascularized with percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). Outcomes included all-cause death, non-fatal myocardial infarction (MI), stroke, PCI or CABG, aneurysm rupture and its endovascular or surgical repair of at 5 years after AA diagnosis. Cochran-Mantel-Haenszel statistics was used to examine associations of CAD with outcomes. RESULTS: One third of the sample had CAD, of which 57% with severe CAD. An abdominal AA was present in 99%. AA patients with CAD had higher major adverse cardiovascular events (MACE) and aneurysm rupture rates than those without (Figure 1.A). Rates of AA endovascular or surgical repair were similar between AA patients with and without CAD (including severe CAD). Severe CAD was significantly associated with an increased risk of 5-year stroke, but not with aneurysm rupture (Figure 1.B). CONCLUSION: Mid-term follow-up of veterans with Aortic Aneurysms revealed that concomitant CAD is associated with an increased risk of all-cause death, non-fatal MI and aneurysm rupture.