Abstract 032: Associations between Middle-age Risk Factors and Future Risk of Abdominal Aortic Aneurysm: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Weihong Tang ◽  
Alvaro Alonso ◽  
Pamela L Lutsey ◽  
Frank A Lederle ◽  
Lu Yao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Middle Age ◽  
Disease Risk ◽  
Atherosclerotic Disease ◽  
Cross Sectional ◽  
Abdominal Aortic ◽  
Aric Study

Introduction: Abdominal aortic aneurysm (AAA) is an important manifestation of vascular disease in older age and rupture of an AAA is a life threatening condition. Traditional atherosclerotic disease risk factors, particularly male sex, smoking and hypertension, are known to contribute to the etiology of AAA. However, epidemiologic studies of AAA have often been cross-sectional, and few have employed a prospective cohort design, especially with long follow-up. The objective of this study was to prospectively assess the association between atherosclerotic disease risk factors and hospitalized AAA in 15,722 participants (68% whites) of the ARIC study, a large, community-based cohort. Methods: Risk factors were measured at baseline at 45-64 year of age. Clinical AAAs were ascertained through hospital discharge diagnoses or death certificates. Over 15 years of follow-up, a total of 265 AAAs (85.3% whites) were identified, including repair procedures, AAA rupture or dissection, and incidental detection. Multivariable Cox proportional hazard models were used to estimate the association of risk factors with the risk of future AAA. Results: Consistent with the literature from prospective studies, we identified age, male gender, white race, smoking, height, total and HDL cholesterols, triglycerides, white blood cell count, and hypertension as risk factors for AAA (Table). In addition, LDL-C, fibrinogen, and peripheral artery disease that were previously reported only in cross-sectional case-control studies were also strongly associated with AAA (Table). Body mass index, diabetes, and alcohol consumption were not associated with AAA occurrence. Conclusions: Several lifestyle and clinical variables measured in middle-age were strong risk factors for future AAA during a long follow-up.

Abstract P341: Associations between Middle-age Risk Factors and Risk of Asymptomatic Abdominal Aortic Aneurysm: the Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Weihong Tang ◽  
Alvaro Alonso ◽  
Pamela L Lutsey ◽  
Frank Lederle ◽  
Lu Yao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Blood Cell ◽  
Cell Count ◽  
Middle Age ◽  
Blood Cell Count ◽  
Abdominal Aortic ◽  
Aric Study

Introduction: Abdominal aortic aneurysm (AAA) is an important cardiovascular disease in older adults and rupture of an AAA is associated with high mortality. Although traditional cardiovascular risk factors have been associated with the risk of AAA, their importance in the etiology of AAA is not well established, partly due to limited data for asymptomatic AAA from large prospective studies with a long follow up. The objective of this study was to prospectively assess the association between mid-life atherosclerotic disease risk factors and later-life asymptomatic AAA in the ARIC Study, a large, community-based cohort. Methods: Risk factors were measured at baseline, at 45-64 years of age, in 1987-1989. Abdominal aortic ultrasound was conducted in 2011-2013. Ultrasound images with maximal infrarenal abdominal aortic diameter (IAD) ≥ 28 mm were over-read by radiologists. Diagnosis of asymptomatic AAA was made in the over-reading based on IAD ≥ 30 mm. Participants who had a history of repair for abdominal aorta or were identified as clinical AAAs via previous hospital discharge diagnoses were excluded. Multivariable logistic regression models were used to estimate the association of baseline risk factors with AAA risk. Results: A total of 113 asymptomatic AAAs were ascertained in 5,904 participants (78% whites) who had an abdominal ultrasound exam (prevalence=1.9%). Age, male gender, white race, smoking, height, total, HDL, and LDL cholesterols, triglycerides, white blood cell count, and fibrinogen were risk factors for asymptomatic AAA (Table). BMI, diabetes, alcohol consumption, hypertension, and peripheral artery disease were not associated with AAA. In multivariable adjustment that included the significant risk factors, age, smoking, height, LDL or total cholesterol, white blood cell count, and fibrinogen remained independently associated with AAA risk (p<0.05). Conclusions: Several lifestyle and clinical variables measured in middle-age were associated with risk of asymptomatic AAA during a long follow up.

Abstract MP47: Associations Between Novel Biomarkers and Risk of Abdominal Aortic Aneurysm: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Weihong Tang ◽  
Lu Yao ◽  
Ron C Hoogeveen ◽  
Alvaro Alonso ◽  
David J Couper ◽  
...  
Keyword(s):  
Risk Factors ◽  
Disease Risk ◽  
Aortic Aneurysms ◽  
Matrix Remodeling ◽  
Cross Sectional ◽  
Blood Concentrations ◽  
Abdominal Aortic ◽  
Novel Biomarkers ◽  
Aric Study

Introduction: Abdominal aortic aneurysms (AAA) are an important manifestation of vascular disease in older age and rupture of an AAA is associated with high mortality. Traditional atherosclerotic disease risk factors contribute to the etiology of AAA. Biomarkers for novel etiopathogenic mechanisms, including extracellular matrix remodeling and inflammation, have been assessed primarily in cross-sectional studies of AAA. The objective of this study was to prospectively assess the association between biomarkers for these novel mechanisms and clinical AAA during 24 years of follow-up in the ARIC study, a large, community-based cohort. Methods: Clinical AAAs were ascertained from baseline in 1987-1989 (45-64 years of age) to 2011 through hospital discharge codes, death codes, and Medicare outpatient claims. Over a maximum 24 years of follow-up, a total of 554 AAAs (85.3% whites) were identified. Using a nested case-cohort design, novel biomarkers, including MMP3, MMP9, IL6, IL1-beta, N-terminal propeptide of Type III procollagen (PIIINP), and osteopontin, were measured at baseline (90% of sample) or Visit 2 (1990-1992, 10% of sample) in all AAAs and a random sample of 747 participants who were selected from baseline and matched with AAAs by age (≤55 and >55), race, and gender. The association of the biomarkers with the risk of future AAA was estimated using multivariable Cox proportional hazard models with weighting to adjust for the varying sampling fractions of cases and controls across strata. Results: MMP9, IL6, PIIINP, and osteopontin were significantly associated with future risk of AAA after adjusting for age, gender, race and field center (Table). The associations for PIIINP and osteopontin were no longer significant after further adjusting for other traditional risk factors for AAA. Conclusions: Blood concentrations of MMP9, IL6, and osteopontin measured in middle-age were risk markers for incident AAA. These results highlight the role of inflammation and extracellular remodeling in the development of AAA.

Risk factors for postoperative cognitive and functional difficulties in abdominal aortic aneurysm patients: a three month follow-up

2010 ◽  
Vol 26 (8) ◽  
pp. 818-824 ◽  
Author(s):  
Harold R. Wallbridge ◽  
Archie G. Benoit ◽  
Douglas Staley ◽  
Jason P. Ediger ◽  
Barry I. Campbell
Keyword(s):  
Risk Factors ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Functional Difficulties ◽  
Abdominal Aortic

Outcome after Endovascular Abdominal Aortic Aneurysm Repair: A Meta-Analysis

2002 ◽  
Vol 9 (1) ◽  
pp. 82-89 ◽  
Author(s):  
Luc H. B. Walschot ◽  
Robert J. F. Laheij ◽  
André L. M. Verbeek
Keyword(s):  
Risk Factors ◽  
Abdominal Aortic Aneurysm ◽  
Postoperative Complications ◽  
Aortic Aneurysm ◽  
Randomized Clinical Trials ◽  
Systemic Complications ◽  
Female Sex ◽  
Abdominal Aortic ◽  
Independent Risk Factors

Purpose: To determine the frequencies of complications and risk factors for complications following endovascular abdominal aortic aneurysm (AAA) repair (EVAR). Methods: Thirty-nine articles published between October 1995 and October 1999 in English, German, French, or Dutch were identified in electronic databases. All articles reported perioperative (30-day) complications on 2387 patients, while postoperative complications (>30 days) were reported on 1645 patients in 30 of 39 studies. Data were pooled and subjected to multivariable logistic regression analysis to identify risk factors for death, endoleak, rupture, conversion, and local and systemic complications. Effects of risk factors were expressed as odds ratios (OR) with 95% confidence interval (CI). Results: Mean follow-up was 13.9 months (range 4–29). The perioperative death rate (3.7%) was lower than postoperative mortality (5.0% per annum). The risks for both endoleak (13.1%) and conversion (5.0%) were higher in the perioperative period than postoperatively (5.4% and 1.4% per annum, respectively). Independent risk factors for perioperative complications were: general anesthesia (death: OR = 5.1, 95% CI 1.9–13.3); EVT graft (endoleak: OR = 3.0, 95% CI 1.3–7.0); female sex (rupture: OR = 2.8, 95% CI 1.4–5.8); hypertension (conversion: OR = 0.03, 95% CI 0.0–0.3); age >70 years (conversion: OR = 3.5, 95% CI 1.3–9.2); and team experience >30 patients (conversion: OR = 3.0, 95% CI 1.2–7.6). Independent risk factors for postoperative complications were: predischarge examination (death: OR = 0.2, 95% CI 0.0–0.7); follow-up 30 days after operation (death: OR = 0.3, 95% CI 0.1–1.0); and female sex (rupture: OR = 1.4, 95% CI 0.5–4.4; conversion: OR 6.8, 95% CI 2.0–23.4; and systemic complications: OR = 2.9, 95% CI 1.1–7.5). Conclusions: The risk of complications after EVAR is high, supporting the cautious use of EVAR. Both patient characteristics and procedural variables were independent risk factors for complications. To avoid the limitations of this study, the results of randomized clinical trials must determine if EVAR offers a safe and durable alternative to open AAA repair.

scholarly journals Middle Age Cardiovascular Risk Factors and Abdominal Aortic Aneurysm in Older Age

Hypertension ◽  
2003 ◽  
Vol 42 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Miriam B. Rodin ◽  
Martha L. Daviglus ◽  
Gordon C. Wong ◽  
Kiang Liu ◽  
Daniel B. Garside ◽  
...  
Keyword(s):  
Risk Factors ◽  
Abdominal Aortic Aneurysm ◽  
Cardiovascular Risk ◽  
Aortic Aneurysm ◽  
Cardiovascular Risk Factors ◽  
Middle Age ◽  
Older Age ◽  
Abdominal Aortic

Abstract 721: Increased Fluorodeoxyglucose Uptake in the Abdominal Aortic Aneurysm (AAA) Wall Significantly Predicts the AAA Expansion Rate

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Kamran Akram ◽  
Gerald Kolodny
Keyword(s):  
Risk Factors ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Fdg Pet ◽  
Two Dimensions ◽  
Fdg Uptake ◽  
Abdominal Aortic ◽  
Pet Ct ◽  
Statin Use

18-Fluorodeoxyglucose (FDG)-PET is capable to image active vascular inflammation. FDG uptake is seen frequently in the wall of abdominal aortic aneurysm (AAA) suggesting active areas of inflammation with unknown clinical significance. We hypothesized that focally increased FDG uptake in the AAA wall predicts accelerated AAA expansion. 20 patients who had a baseline oncologic PET/CT study and a follow-up PET/CT or CT study after 1 year were included. The AAA size in two dimensions and maximum standardized uptake value (maxSUV) in focally increased FDG uptake in the AAA wall on the baseline PET/CT and the AAA size on the follow-up study were recorded in similar position. A difference greater than 1 mm in size on repeated measurements in the largest dimension between the first and second study defined AAA progression. ROC curve analysis and t-test were used for statistical analysis. A p-value<0.05 defined statistical significance. 13/20 (65%) had an increase (G1), 7/20 (35%) had stable (G2) AAA size. Cardiovascular risk factors were similar between the groups (Male 53%, HTN 80%, Hypercholesterolemia 60%, DM 13%, Smoker 53%, CAD or CAD equivalent 100%, Statin use 53%). Mean AAA growth in G1 and G2 was 4.2 and 0.86 mm/year, respectively. Mean maxSUV in the AAA wall was significantly higher for G1 compared to G2 (2.88 vs. 2.03, p=0.0004). ROC analysis showed FDG uptake in the AAA wall to be an excellent test to predict AAA expansion as evidenced by an AUC=0.95. A maxSUV of 2.45 served as best cut-point to predict AAA expansion (sensitivity 92%, specificity 86%, p<0.001). The correlation between maxSUV and degree of AAA expansion was r=0.7 (p<0.001). After adjusting for all risk factors and statin use the maxSUV remained an independent predictor of AAA size progression (p=0.007). This is the first study to demonstrate that FDG uptake in the AAA wall significantly predicts the AAA size expansion. FDG-PET/CT may provide a mean to identify patients at high risk of AAA expansion and rupture.

scholarly journals Peripheral Artery Disease and Abdominal Aortic Aneurysm: The Forgotten Diseases in COVID-19 Pandemic. Results from an Observational Study on Real-World Management

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 672
Author(s):  
Francesco Natale ◽  
Raffaele Capasso ◽  
Alfonso Casalino ◽  
Clotilde Crescenzi ◽  
Paolo Sangiuolo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Peripheral Artery Disease ◽  
Absolute Risk ◽  
Lipid Lowering ◽  
Peripheral Artery ◽  
Abdominal Aortic ◽  
Artery Disease

Background and Objectives: It is well established that patients with peripheral artery disease (PAD) as well abdominal aortic aneurysm (AAA) have an increased cardiovascular (CV) mortality. Despite this higher risk, PAD and AAA patients are often suboptimality treated. This study assessed the CV profile of PAD and AAA patients, quantifying the survival benefits of target-based risk-factors modification even in light of the COVID-19 pandemic. Materials and Methods: PAD and AAA patients admitted for any reason to the Vascular Unit from January 2019 to February 2020 were retrospectively analyzed. Biochemical and CV profiles as well as ongoing medical therapies were recorded. Benefits of CV risk-factors control were estimated using the SMART-REACH model. A follow-up visit during the year 2020 was scheduled. Results: A total of 669 patients were included. Of these, 190 showed AAA and 479 PAD at any stage. Only 54% of PAD and 41% of AAA patients were on lipid-lowering drugs with non-optimal low-density lipoprotein (LDL) levels for most of them. A better control of all modifiable CV risk-factors based on the current guidelines would offer an absolute risk reduction of the mean 10-year CV risk by 9% in PAD and 14% in AAA. Unfortunately, the follow-up visit was lost because of COVID-19 limitations. Conclusions: Lipid profiles of PAD and AAA patients were far from guideline-based targets, and medical management was suboptimal. In our center, the COVID-19 pandemic impacted on the strict surveillance required in these very high-risk patients. The achievement of guideline-based therapeutic targets would definitively confer additional significant benefits in reducing the CV risk in these patients.

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