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Panminerva Medica 1998 June;40(2):107-9

lingua: Inglese

Routine cor­o­nary angio­gra­phy prior to abdom­i­nal aor­tic aneu­rysm ­repair: incidence of ­silent cor­o­nary ­artery dis­ease

Utoh J., Goto H., Hirata T., Hara M., Kitamura N.

From ­the First Department of Surgery, Kumamoto University School of Medicine, Kumamoto 860, Japan


Objective. Routine cor­o­nary angio­gram (­CAG) ­was per­formed in ­patients ­prior to elec­tive ­repair of abdom­i­nal aor­tic aneur­ysm (­AAA) to esti­mate ­the inci­dence of cor­o­nary ­artery dis­ease (­CAD) ­and to com­pare ­with ­risk fac­tors ­for ­CAD ­and rest­ing elec­tro­car­di­o­gram (­ECG).
Methods. History of ­CAD, ­risk fac­tors ­for ­CAD, rest­ing ­ECG, ­and stan­dard ­CAG ­were ­assessed in 50 con­sec­u­tive AAA ­patients.
Results. Nine ­patients ­had a his­to­ry of ­CAD. Risk fac­tors includ­ed: smok­ing in 82%, hyper­ten­sion in 58%, hyper­cho­les­ter­o­le­mia in 42%, ­and dia­betes in 18%. ­CAG ­revealed ­that 46% of ­the ­patients ­had ­severe ­CAD ­with great­er ­than a 75% sten­o­sis of ­one or ­more cor­o­nary arter­ies. There ­was no rela­tion­ship ­between ­the num­ber of ­risk fac­tors ­and prev­a­lence of ­CAD. Eleven ­patients ­who ­had ­severe ­CAD as detect­ed by ­CAG ­had no his­to­ry of ­CAD ­and dis­played no ischem­ic find­ings on ­ECG. No per­i­op­er­a­tive myo­car­dial infarc­tions or ­angial ­attacks ­were not­ed ­despite ­the ­absence of pro­phy­lac­tic cor­o­nary inter­ven­tions or revas­cu­lar­iza­tions.
Conclusions. The prev­a­lence of ­severe ­CAD ­was 46% ­and inci­dence of ­silent ­CAD ­was 22% in ­this ­AAA pop­u­la­tion. The num­bers of cor­o­nary ­risk fac­tors ­and rest­ing ­ECG ­were ­not worth­while ­for pre­dict­ing ­silent ­CAD.

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