Korean Circ J.  2014 May;44(3):162-169. 10.4070/kcj.2014.44.3.162.

Aortic Aneurysm Screening in a High-Risk Population: A Non-Contrast Computed Tomography Study in Korean Males with Hypertension

• Cho IJ
• Jang SY
• Chang HJ
• Shin S
• Shim CY
• Hong GR
• Chung N

• KMID: 2145477
• DOI: http://doi.org/10.4070/kcj.2014.44.3.162

Abstract

BACKGROUND AND OBJECTIVES
Screening strategies for aortic aneurysm (AA) according to risk factors and ethnicity are controversial. This study explored the prevalence of AA and determined whether screening is necessary in a population of multiple risk factors.
SUBJECTS AND METHODS
From June, 2012 to April, 2013, 542 consecutive elderly (> or =65 years) male hypertensive patients without a history of AA were prospectively enrolled. After excluding 15 patients (2.8%) with aortic valve surgery, 30 patients (5.5%) with suboptimal computed tomography (CT) images, the remaining 496 patients (age 73+/-5 years) comprised the study population. Maximal diameters of the thoracic and abdominal aorta were measured using non-contrast CT.
RESULTS
The prevalence of thoracic AA (TAA, diameter > or =40 mm) and abdominal AA (AAA, diameter > or =30 mm) was 36.5% (181/496) and 6.0% (30/496), respectively. In the multivariate logistic regression analysis, determinants for TAA were age {odds ratio (OR) 1.059, 95% confidence interval (CI) 1.018-1.101, p=0.005}, dyslipidemia (OR 0.621, 95% CI 0.418-0.923, p=0.018), body surface area (OR 11.92, 95% CI 2.787-50.97, p=0.001), diastolic blood pressure (OR 1.029, 95% CI 1.009-1.049, p=0.004) and AAA (OR 3.070, 95% CI 1.398-6.754, p=0.005). In contrast, AAA was independently associated with dysplipidemia (OR 2.792, 95% CI 1.091-7.143, p=0.032), current/past smokerfs (OR 4.074, 95% CI 1.160-14.31, p=0.028), and TAA (OR 3.367, 95% CI 1.550-7.313, p=0.002).
CONCLUSION
The prevalence of AA was significant and TAA was more prevalent than AAA in elderly Korean males with hypertension. Future research should establish distinct screening strategies for TAA and AAA according to risk factors and ethnicity.

Keyword

Aorta; Aneurysm; Prevalence; Computed tomography

MeSH Terms

Aged
Aneurysm
Aorta
Aorta, Abdominal
Aortic Aneurysm*
Aortic Valve
Blood Pressure
Body Surface Area
Dyslipidemias
Humans
Hypertension*
Logistic Models
Male
Mass Screening*
Prevalence
Prospective Studies
Risk Factors

Figure

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  Fig. 1 Measurement of aortic diameter in the axial plane. Ascending and descending thoracic aorta (A) and abdominal aorta (B). ATA: ascending thoracic aorta, DTA: descending thoracic aorta, AA: abdominal aorta.

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  Fig. 2 Reconstructed images of aorta using non-contrast computed tomography. Reconstructed sagittal (A) and coronal (B) images of aorta.

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  Fig. 3 Histogram of maximal thoracic (A) and abdominal aorta (B). Red lines indicate maximal thoracic aorta of 40 mm and maximal abdominal aorta of 30 mm. TAMAX: maximal thoracic aorta, AAMAX: maximal abdominal aorta.

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  Fig. 4 Prevalence of thoracic aortic aneurysm in patients with and without abdominal aortic aneurysm. TAA (-), patients without thoracic aortic aneurysm; TAA (+), patients with thoracic aortic aneurysm; AAA (+), patients with abdominal aortic aneurysm; AAA (-), patients without abdominal aortic aneurysm.

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  Fig. 5 Prevalence of thoracic aortic aneurysm (A) and abdominal aortic aneurysm (B) according to history of smoking. Smoking (+), current or past smoker; Smoking (-), never smoked.

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