Abstract
In this study, the coronary findings in 185 autopsy cases with a ruptured abdominal aortic aneurysm (AAA) from the Tokyo Medical Examiner’s Office were examined and compared with those in 1,056 patients undergoing AAA repair at the University of Tokyo Hospital or Sakakibara Heart Institute (Tokyo, Japan). The number of cases with any significant coronary stenosis was significantly greater in the autopsy cases with a ruptured AAA than in the patients undergoing emergency repair of a ruptured AAA, suggesting that the low prevalence of CAD observed in patients undergoing emergency repair of a ruptured AAA was due to the survival bias before reaching hospital. In addition, we also found that significant coronary left main trunk stenosis was more frequent in CAD cases with a ruptured AAA than in those with an unruptured AAA, findings that suggest novel clinical implications. Large-scale prospective studies are warranted to confirm our findings and to clarify the pathophysiological relationship between coronary atherosclerosis and AAA status.
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References
Bown MJ, Sutton AJ, Bell PR, Sayers RD (2002) A meta-analysis of 50 years of ruptured abdominal aortic aneurysm repair. Br J Surg 89:714–730
Nakayama A, Morita H, Miyata T, Hoshina K, Nagayama M, Takanashi S, Sumiyoshi T, Komuro I, Nagai R (2014) Predictors of mortality after emergency or elective repair of abdominal aortic aneurysm in a Japanese population. Heart Vessel 29:65–70
(2006) Guidelines for diagnosis and treatment of aortic aneurysm and aortic dissection (JCS 2006) (in Japanese). Circ J 70(Suppl IV):1569–1646
Chida K, Ohkawa S, Watanabe C, Shimada H, Ohtsubo K, Sugiura M (1994) A morphological study of the normally aging heart. Cardiovasc Pathol 3:1–7
Nakayama A, Morita H, Miyata T, Ando J, Fujita H, Ohtsu H, Akai T, Hoshina K, Nagayama M, Takanashi S, Sumiyoshi T, Nagai R (2012) Inverse association between the existence of coronary artery disease and progression of abdominal aortic aneurysm. Atherosclerosis 222:278–283
Brady AR, Thompson SG, Fowkes FG, Greenhalgh RM, Powell JT, UK Small Aneurysm Trial Participants (2004) Abdominal aortic aneurysm expansion: risk factors and time intervals for surveillance. Circulation 110:16–21
Tomanek RJ (2005) Formation of the coronary vasculature during development. Angiogenesis 8:273–284
Trask N, Califf RM, Conley MJ, Kong Y, Peter R, Lee KL, Hackel DB, Wagner GS (1984) Accuracy and interobserver variability of coronary cineangiography: a comparison with postmortem evaluation. J Am Coll Cardiol 3:1145–1154
Oishi Y, Miyoshi H, Iuchi A, Nagase N, Ara N, Oki T (2013) Vascular aging of common carotid artery and abdominal aorta in clinically normal individuals and preclinical patients with cardiovascular risk factors: diagnostic value of two-dimensional speckle-tracking echocardiography. Heart Vessel 28:222–228
Acknowledgments
This research is supported by grants-in-aid from the Ministry of Health, Labour and Welfare, Japan (to HM and TM). The authors have no conflicts of interest to declare.
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Nakayama, A., Morita, H., Hamamatsu, A. et al. Coronary atherosclerotic lesions in patients with a ruptured abdominal aortic aneurysm. Heart Vessels 30, 304–308 (2015). https://doi.org/10.1007/s00380-014-0488-5
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DOI: https://doi.org/10.1007/s00380-014-0488-5