Prevalence of abdominal aortic aneurysm in patients referred for transthoracic echocardiography

• Published in: Internal medicine journal 2015-01, Vol.45 (1), p.32-39
• Main Authors: Majeed, K., Hamer, A. W., White, S. C., Pegg, T. J., Wilkins, G. T., Williams, S. M., Chen, Y. H., Williams, M. J. A.
• Format: Article
• Language: English
• Subjects: abdominal aortic aneurysm; Aged; Aortic Aneurysm, Abdominal - diagnostic imaging; Aortic Aneurysm, Abdominal - epidemiology; echocardiography; Echocardiography - methods; Female; Follow-Up Studies; Humans; Male; Middle Aged; New Zealand - epidemiology; Prevalence; Referral and Consultation; Retrospective Studies; risk factor; Risk Factors; screening
• ISSN: 1444-0903; 1445-5994
• DOI: 10.1111/imj.12592

Background Previous studies have documented the prevalence of abdominal aortic aneurysm (AAA) during transthoracic echocardiography, but the effect of such screening on subsequent vascular interventions remains unclear. Aim This study aimed to determine the utility of opportunistic selective screening for AAA in a contemporary large series of patients having transthoracic echocardiography. Methods Subjects aged 50 years or older having transthoracic echocardiography had scanning of the infrarenal aorta in a consecutive series of 10 403 men and women. Results The study subjects had a mean age of 70.2 ± 10.7 years, and 54.1% were men. There was a 3.5% (95% confidence interval (CI) 3.2–3.9%) prevalence of AAA with a median diameter of 39 mm (interquartile range 32 mm–48 mm). In males ≥ 65 years the prevalence of newly diagnosed AAA was 6.2% (95% CI 5.5–7.0%). Of those with newly diagnosed AAA, 39.7% underwent AAA repair. Age and male gender were associated with AAA prevalence. After adjustment for age and gender, echocardiographic variables associated with AAA were left ventricular end diastolic dimension (odds ratio (OR) 1.02, 95%CI 1.01–1.04), interventricular septum thickness (OR 1.11, 95% CI 1.06–1.17), left ventricular posterior wall thickness (OR 1.09, 95% CI 1.03–1.15), left atrial diameter (OR 1.04, 95% CI 1.02–1.07) and aortic root diameter (OR 1.09, 95% CI 1.06–1.11). Conclusions This study revealed a high prevalence of newly diagnosed AAA in a group of older men having cardiac evaluation. There was a relationship of increasing age with AAA, and a significant proportion of newly diagnosed subjects were not suitable for AAA repair.