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Early Detection of Undiagnosed Abdominal Aortic Aneurysm and Sub-Aneurysmal Aortic Dilatations in Patients with High-Risk Coronary Artery Disease: The Value of Targetted Screening Programme

Authors Saw ST, Leong BDK, Abdul Aziz DA

Received 24 February 2020

Accepted for publication 26 May 2020

Published 9 June 2020 Volume 2020:16 Pages 215—229


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Pietro Scicchitano

Siong Teng Saw, 1 Benjamin Dak Keung Leong, 2 Dayang Anita Abdul Aziz 3

1Faculty of Medicine, Universiti Kebangsaan Malaysia; Hospital Queen Elizabeth II, Kota Kinabalu, Sabah 88300, Malaysia; 2Hospital Queen Elizabeth II, Kota Kinabalu, Sabah 88300, Malaysia; 3Faculty of Medicine, Universiti Kebangsaan Malaysia, UKM Medical Center, Kuala Lumpur 56000, Malaysia

Correspondence: Dayang Anita Abdul Aziz Fax +603 9145 6684
Email [email protected]

Introduction: Abdominal aortic aneurysm (AAA) and coronary artery disease (CAD) share common risk factors. The objective of this study was to determine the prevalence of undiagnosed AAA in patients with angiographically diagnosed significant CAD.
Patients and Methods: Male patients aged 50 years and above (including indigenous people) with angiographically diagnosed significant CAD in the recent one year were screened for AAA. Standard definition of abdominal aortic aneurysm and CAD was used. All new patients were followed up for six months for AAA events (ruptured AAA and AAA-related mortality).
Results: A total of 277 male patients were recruited into this study. The total prevalence of undiagnosed AAA in this study population was 1.1% (95% CI 0.2– 3.1). In patients with high-risk CAD, the prevalence of undiagnosed AAA was 1.7% (95% CI 0.3– 4.8). The detected aneurysms ranged in size from 35.0mm to 63.8mm. Obesity was a common factor in these patients. There were no AAA-related mortality or morbidity during the follow-up. Although the total prevalence of undiagnosed AAA is low in the studied population, the prevalence of sub-aneurysmal aortic dilatation in patients with significant CAD was high at 6.6% (95% CI 3.9– 10.2), in which majority were within the younger age group than 65 years old.
Conclusion: This was the first study on the prevalence of undiagnosed AAA in a significant CAD population involving indigenous people in the island of Borneo. Targeted screening of patients with high-risk CAD even though they are younger than 65 years old effectively discover potentially harmful asymptomatic AAA and sub-aneurysmal aortic dilatations.

Keywords: abdominal aortic aneurysm, sub-aneurysmal aortic dilatation, coronary artery disease

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