The abdominal aortic aneurysm diameter might predict the coexistence of coronary artery disease in candidates to surgical or endovascular repair

BACKGROUND: Coronary artery disease (CAD) can be revealed in many patients with an abdominal aortic aneurysm (AAA). Aim of this study was to evaluate a possible relationship between aneurysm diameter and incidence of CAD in patients scheduled for AAA repair.METHODS: A retrospective, observational, cohort study on a series of 139 patients with no previous myocardial infarction or any coronary revascularization procedures, undergoing preoperative coronary angiography before elective AAA repair (January 2013 to December 2023). According to aneurysm diameter, the population study was classified in eight groups: Group 1 (AAA≤40), Group 2 (4070). The incidence of CAD and the need of coronary revascularization was determined for each group.RESULTS: CAD was revealed in 78 patients (56.1%), most of them (N.=66, 47.5%) requiring coronary artery revascularization. The incidence of CAD increased in the eight groups from 30.7% in Group 1 (AAA≤40) to 75% in Group 8 (AAA>70), showing a linear progression according to the aneurysm diameter. Similarly, the need of coronary revascularization increased from 15.3% in Group 1 (AAA≤40) to 75% in Group 8 (AAA>70).CONCLUSIONS: The present study seems to confirm a direct relationship between aneurysm diameter and incidence of CAD, showing a progressive severity of coronary disease as the diameter of the aneurysm increases. This data suggests to properly consider the coronary risk in most patients with small and large aneurysms.