Screening Men with Coronary Heart Disease for Abdominal Aortic Aneurysm: A Prospective Cohort Study

Background The prevalence of abdominal aortic aneurysms (AAA) is higher among patients with coronary heart disease (CHD) compared with control population. Objective To assess and determine the prevalence of non-diagnosed AAA in men with CHD. Materials and methods A total of 438 active male out-patients with CHD were screened for AAA by abdominal ultrasound (US) examination. The largest infrarenal aortic dimension was registered. The patient was regarded to have AAA when the aortic diameter was greater than 30 mm. Results We found altogether 25 AAAs. The incidence of AAA was 5.7 %. One AAA patient was operated on, and the other AAA patients are under surveillance. Independent predictors for AAA among CHD patients were increased age, family history of AAA, and current or previous smoking. The screening process took on average 5 min per patient, and the cost of screening was 15€ ($18.50) per patient or €257 ($325) per found AAA. Conclusions The prevalence of previously undiagnosed AAAs among patients with CHD is considerable. Screening of AAA should be considered among active patients with CHD. The most feasible and simplest option would be to perform the screening during any routine or elective cardiac US by a cardiologist, and we recommend to adopt it as a standard practice.