Research Article
Abdominal Aortic Aneurysms and Coronary Artery Disease
in a Small Country with High Cardiovascular Burden
Hassan Al-Thani
1,2
and Ayman El-Menyar
3,4,5
1
Vascular Surgery, Hamad General Hospital, P.O. Box 3050, Doha, Qatar
2
General Surgery, Hamad General Hospital, Doha, Qatar
3
Clinical Research, Hamad General Hospital, HMC, P.O. Box 3050, Doha, Qatar
4
Clinical Medicine, Weill Cornell Medical School, P.O. Box 24144, Doha, Qatar
5
Cardiology Unit, Internal Medicine, Ahmed Maher Teaching Hospital, Cairo, Egypt
Correspondence should be addressed to Ayman El-Menyar; aymanco65@yahoo.com
Received 24 November 2013; Accepted 13 January 2014; Published 20 February 2014
Academic Editors: A. Becker, J. A. F. Ramires, and A. Stephanou
Copyright © 2014 H. Al- hani and A. El-Menyar. his is an open access article distributed under the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
We aimed to evaluate the frequency, clinical proiles and outcomes of abdominal aortic aneurysms (AAA), and their association
with coronary artery disease (CAD) in a small country with high cardiovascular burden. Methods. Data were collected for all adult
patients who underwent abdominal computed tomography scans at Hamad General Hospital in Qatar between 2004 and 2008.
Results. Out of 13,115 screened patients for various reasons, 61 patients (0.5%) had abdominal aneurysms. he majority of AAA
patients were male (82%) with a mean age of 67 ± 12 years. he incidence of AAA substantially increased with age reaching up
to 5% in patients >80yrs. Hypertension was the most prevalent risk factor for AAA followed by smoking, dyslipidemia, renal
impairment, and diabetes mellitus. CAD and peripheral arterial disease (PAD) were observed in 36% and 13% of AAA patients,
respectively. here were no signiicant correlations between CAD or PAD and site and size of AAA. Conclusion. his is the largest
study in our region that describes the epidemiology of AAA with concomitant CAD. As the mortality rate is quite high in this high
risk population, routine screening for AAA in CAD patients and vice versa needs further studies for proper risk stratiication.
1. Introduction
Screening programs for abdominal aortic aneurysm (AAA)
are lacking in the developing countries. Global data reported
that the prevalence of AAA varies in men (1.3%–8.9%) and
women (11%–2.2%) [1].
he rising incidence of AAA is related mainly to the
increase in age, physician awareness with clinical high index
of suspicion, and the use of advanced diagnostic modali-
ties. As AAA is a silent process, it may present only with
aneurysmal rupture in most of cases. It was believed for
a long time that atherosclerosis is the main pathogenesis
of AAA. However, this speculation has raised a question
that whether atherosclerosis is a “bystander” condition or
an active factor for the initiation or acceleration of AAA
[1, 2].
In a systematic review, Elkalioubie et al. evaluated 17
published studies between 1991 and 2010 [1]. he authors
found that the frequency of AAA among coronary artery
disease patients ranged between 0.48% and 18.2% [1]. As
advanced age is a potential risk factor for both coronary
artery disease and AAA, ive studies speciically recruited
patients who were above 60 years. Salem et al. [3] reported a
lower prevalence of AAA among men of Asian origin (China
and Iran), indicating that certain ethnic groups experience
a disproportionately smaller burden of AAA. Notably, the
prevalence of AAA in coronary artery disease patients was
comparable to that reported in AAA screening studies among
patients with diferent vascular bed afection such as periph-
eral vascular disease (PAD) (7%–17%) and cerebrovascular
disease (8.4%–20.2%) [1, 4, 5]. Herein, we aim to evaluate
the frequency, clinical proiles and outcomes of AAA, and
Hindawi Publishing Corporation
ISRN Cardiology
Volume 2014, Article ID 825461, 4 pages
http://dx.doi.org/10.1155/2014/825461