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Kim H, Cho S, Sakalihasan N, Hultgren R, Joh JH. Prevalence and Risk Factors of Abdominal Aortic Aneurysms Detected with Ultrasound in Korea and Belgium. J Clin Med 2023; 12:jcm12020484. [PMID: 36675413 PMCID: PMC9861924 DOI: 10.3390/jcm12020484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/28/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
The objective was to investigate the prevalence of abdominal aortic aneurysms (AAAs) and the diameters of the aorta and common iliac arteries (CIAs) in a Korean cohort and secondly to analyze the differences in aortic diameter by comparison with a European cohort. The Korean cohort included participants ≥ 50 years who consented to AAA screening and data were analysed retrospectively. Aortic and common iliac diameters were measured using the outer-to-outer diameter method and prevalence rates were calculated. Common risk factors such as smoking, body mass index, pulmonary disease, hypertension, diabetes, hyperlipidaemia, ischaemic heart disease, and cerebrovascular disease were reported in association with AAA occurrence and AAA development. The aortic diameters were then compared with those in a Belgian cohort of 2487 participants identified in the Liège AAA Screening Program. An aortic size index (ASI) was also calculated to account for the potential size differences in the Belgian and Korean populations. A total of 3124 Korean participants were examined using ultrasound. The prevalence of AAAs in this cohort was 0.7%. The combined prevalence of subaneurysmal dilatation and AAA was 1.5%. The prevalence in male smokers older than 65 years was 2.7% (19/715). The mean infrarenal aortic diameter was 17.3 ± 3.1 mm in men and 15.7 ± 2.7 mm in women; the corresponding values in Belgian participants were 19.4 ± 3.0 mm in men and 17.9 ± 2.4 mm in women. The median aortic size index was 0.99 (interquartile range 0.88-1.12). The mean infrarenal aortic diameter was significantly smaller in the Korean cohort than in the Belgian cohort. Considering the observed prevalence of AAAs in different age groups, the age groups which would contribute to most cases was male persons above 66 years in both cohorts.
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Affiliation(s)
- Hyangkyoung Kim
- Department of Surgery, Ewha Womans University College of Medicine, Ewha Womans University Medical Center, Seoul 07985, Republic of Korea
| | - Sungsin Cho
- Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul 05278, Republic of Korea
| | - Natzi Sakalihasan
- Department of Cardiovascular and Thoracic Surgery, Centre Hospitalier Universitaire Liège, University of Liège, 4000 Liège, Belgium
| | - Rebecka Hultgren
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 17177 Solna, Sweden
- Department of Vascular Surgery, Karolinska University Hospital, 17164 Stockholm, Sweden
| | - Jin Hyun Joh
- Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul 05278, Republic of Korea
- Correspondence: ; Tel.: +82-2-440-6261
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Construction of the circRNA-miRNA-mRNA Regulatory Network of an Abdominal Aortic Aneurysm to Explore Its Potential Pathogenesis. DISEASE MARKERS 2021; 2021:9916881. [PMID: 34777635 PMCID: PMC8589483 DOI: 10.1155/2021/9916881] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/29/2021] [Accepted: 10/20/2021] [Indexed: 01/20/2023]
Abstract
Background Abdominal aortic aneurysm (AAA) is a progressive cardiovascular disease, which is a permanent and localized dilatation of the abdominal aorta with potentially fatal consequence of aortic rupture. Dysregulation of circRNAs is correlated with the development of various pathological events in cardiovascular diseases. However, the function of circRNAs in abdominal aortic aneurysm (AAA) is unknown and remains to be explored. This study is aimed at determining the regulatory mechanisms of circRNAs in AAAs. This study was aimed at exploring the underlying molecular mechanisms of abdominal aortic aneurysms based on the competing endogenous RNA (ceRNA) regulatory hypothesis of circRNA, miRNA, and mRNA. Methods The expression profiles of circRNAs (GSE144431), miRNAs (GSE62179), and mRNAs (GSE7084, GSE57691, and GSE47472) in human tissue sample from the aneurysm group and normal group were obtained from the Gene Expression Omnibus database, respectively. The circRNA-miRNA-mRNA network was constructed by using Cytoscape 3.7.2 software; then, the protein-protein interaction (PPI) network was constructed by using the STRING database, and the hub genes were identified by using the cytoHubba plug-in. The circRNA-miRNA-hub gene regulatory subnetwork was formed to understand the regulatory axis of hub genes in AAAs. Results The present study identified 40 differentially expressed circRNAs (DECs) in the GSE144431, 90 differentially expressed miRNAs (DEmiRs) in the GSE62179, and 168 differentially expressed mRNAs (DEGs) with the same direction regulation (130 downregulated and 38 upregulated) in the GSE7084, GSE57691, and GSE47472 datasets identified regarding AAAs. The miRNA response elements (MREs) of three DECs were then predicted. Four overlapping miRNAs were obtained by intersecting the predicted miRNA and DEmiRs. Then, 17 overlapping mRNAs were obtained by intersecting the predicted target mRNAs of 4 miRNAs with 168 DEGs. Furthermore, the circRNA-miRNA-mRNA network was constructed through 3 circRNAs, 4 miRNAs, and 17 mRNAs, and three hub genes (SOD2, CCR7, and PGRMC1) were identified. Simultaneously, functional enrichment and pathway analysis were performed within genes in the circRNA-miRNA-mRNA network. Three of them (SOD2, CCR7, and PGRMC1) were suggested to be crucial based on functional enrichment, protein-protein interaction, and ceRNA network analysis. Furthermore, the expression of SOD2 and CCR7 may be regulated by hsa_circ_0011449/hsa_circ_0081968/hsa-let-7f-5p; the expression of PGRMC1 may be regulated by hsa_circ_0011449/hsa_circ_0081968-hsa-let-7f-5p/hsa-let-7e-5p. Conclusion In conclusion, the ceRNA interaction axis we identified may be an important target for the treatment of abdominal aortic aneurysms. This study provided further understanding of the potential pathogenesis from the perspective of the circRNA-related competitive endogenous RNA network in AAAs.
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Rao A, Mehta A, Lazar AN, Siracuse J, Garg K, Schermerhorn M, Takayama H, Patel VI. The Association Between Preoperative Independent Ambulatory Status and Outcomes After Open Abdominal Aortic Aneurysm Repairs. Ann Vasc Surg 2021; 81:70-78. [PMID: 34785339 DOI: 10.1016/j.avsg.2021.10.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Preoperative functional status is appreciated as a key determinant of decision-making when evaluating patients for complex elective surgeries. We used the Vascular Quality Initiative (VQI) to analyze the effect of being able to independently ambulate on outcomes after open abdominal aortic aneurysm (AAA) repairs. METHODS We identified all patients who underwent elective or urgent open AAA repairs from January 2013 to August 2019 in the VQI registry. We recorded demographic variables, comorbidities, and operative factors such as approach, operative ischemia time, proximal clamp site, and presence of iliac aneurysms. Short-term and long-term outcomes included 30-day mortality, any perioperative complications, failure to rescue (defined as death after a complication), and one-year all-cause mortality. We dichotomized patients based on their ability to independently ambulate (Ambulatory) or inability to ambulate independently (Non-Ambulatory) and used both multivariable logistic regressions and cox-proportional hazards models to evaluate outcomes. RESULTS Of 5,371 patients, 328 (6.1%) could not ambulate independently and were more likely to be older (median age 69 vs 72), female (25% vs. 38%), and have greater comorbidities. Overall outcomes were: 4.3% for 30-day mortality, 38.7% for complications, 10.2% for failure-to-rescue, and 6.9% for one-year mortality. Univariate analysis showed higher rates of all adverse outcomes in non-ambulatory patients. On adjusted analysis, non-ambulatory patients had increased odds of complications by 46% (OR 1.46 [95%-CI 1.11-1.91]) and one-year mortality by 46% (HR 1.46 [95%-CI 1.06-1.99]), but not failure to rescue (OR 1.05 [95%-CI 0.67-1.62]) or 30-day mortality (OR 1.22 [95%-CI 0.82-1.81]). Increased hospital volume, age, and increased operative renal ischemia time were independently associated with adverse outcomes. CONCLUSIONS Non-ambulatory status was observed in a small percentage of patients undergoing open AAA repair but was associated with higher rates of post-operative complications and one-year mortality. Ambulatory capacity is one of the key determinants of outcomes following open AAA repair. In patients with poor ambulatory function, a conservative approach is highly recommended over invasive open surgical intervention.
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Affiliation(s)
- Abhishek Rao
- Division of Cardiac, Thoracic, and Vascular Surgery, Department of Surgery, Columbia University Medical Center, 161 Fort Washington Avenue, New York, NY, 10032 (USA)
| | - Ambar Mehta
- Division of Cardiac, Thoracic, and Vascular Surgery, Department of Surgery, Columbia University Medical Center, 161 Fort Washington Avenue, New York, NY, 10032 (USA)
| | - Andrew N Lazar
- Division of Cardiac, Thoracic, and Vascular Surgery, Department of Surgery, Columbia University Medical Center, 161 Fort Washington Avenue, New York, NY, 10032 (USA).
| | - Jeffrey Siracuse
- Division of Vascular and Endovascular Surgery, Boston Medical Center, 732 Harrison Avenue, 3(rd) Floor, Boston, MA, 02118 (USA)
| | - Karan Garg
- Division of Vascular and Endovascular Surgery, Department of Surgery, New York University, 530 1(st) Avenue, 11(th) Floor, New York, NY, 10016 (USA)
| | - Marc Schermerhorn
- Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street, STE 5B, Boston, MA, 02215 (USA)
| | - Hiroo Takayama
- Division of Cardiac, Thoracic, and Vascular Surgery, Department of Surgery, Columbia University Medical Center, 161 Fort Washington Avenue, New York, NY, 10032 (USA)
| | - Virendra I Patel
- Division of Cardiac, Thoracic, and Vascular Surgery, Department of Surgery, Columbia University Medical Center, 161 Fort Washington Avenue, New York, NY, 10032 (USA)
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Li LY, Chien WC, Wang JC, Tzeng NS, Chung CH, Lin CY, Tsai SH. Association between abdominal aortic aneurysms and alcohol-related diseases. Medicine (Baltimore) 2020; 99:e22968. [PMID: 33126369 PMCID: PMC7598798 DOI: 10.1097/md.0000000000022968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Heterogeneous associations exist between alcohol consumption and the initial presentation of cardiovascular diseases (CVDs). Studies regarding the association between abdominal aortic aneurysms (AAAs) and alcohol consumption are still limited and controversial. We hypothesize that patients with alcohol-related diseases are susceptible to AAA formation due to the presence of overlapping epidemiological factors and molecular mechanisms. We aimed to use a nationwide population-based retrospective cohort study to evaluate the association between alcohol-related diseases and AAA.The data were extracted from the National Health Insurance Research Database (NHIRD) in Taiwan. The study outcome assessed was the cumulative incidence of AAA in patients with alcohol-related diseases during a 14-year follow-up period.Our study included 22,878 patients who had alcohol-related diseases; these patients with alcohol-related diseases had a significantly higher cumulative risk of developing AAA 5 years after the index date than did the 91,512 patients without alcohol-related diseases. Patients with alcohol-related diseases also exhibited a significantly increased incidence of AAA compared with the incidence among patients without alcohol-related diseases, according to Cox regression analysis and Fine & Gray's competing risk model (adjusted hazard ratio = 2.379, 95% confidence interval = 1.653 -3.424, P < .001). In addition, male gender, older age, and chronic kidney disease were also associated with an increased risk of developing AAA. An interaction model showed that males with alcohol-related diseases had a 10.4-fold higher risk of AAA than did females without alcohol-related diseases.We observed an association between alcohol-related diseases and AAA even after adjusting for several comorbidities and medications in a nationwide population database.
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Affiliation(s)
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital
- School of Public Health, National Defense Medical Center
- Taiwanese Injury Prevention and Safety Promotion Association
| | - Jen-Chun Wang
- Department of Emergency Medicine
- Institute of Clinical Medicine, National Yang-Ming University
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital
- Student Counseling Center
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital
- School of Public Health, National Defense Medical Center
- Taiwanese Injury Prevention and Safety Promotion Association
| | - Chih-Yuan Lin
- Department of Surgery, Division of Cardiovascular Surgery, Tri-Service General Hospital
| | - Shih-Hung Tsai
- Department of Emergency Medicine
- Department of Physiology and Biophysics, Graduate Institute of Physiology, National Defense Medical Center, Taipei, Taiwan
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Saw ST, Leong BDK, Abdul Aziz DA. Early Detection of Undiagnosed Abdominal Aortic Aneurysm and Sub-Aneurysmal Aortic Dilatations in Patients with High-Risk Coronary Artery Disease: The Value of Targetted Screening Programme. Vasc Health Risk Manag 2020; 16:215-229. [PMID: 32606718 PMCID: PMC7293413 DOI: 10.2147/vhrm.s250735] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/26/2020] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Abdominal aortic aneurysm (AAA) and coronary artery disease (CAD) share common risk factors. The objective of this study was to determine the prevalence of undiagnosed AAA in patients with angiographically diagnosed significant CAD. PATIENTS AND METHODS Male patients aged 50 years and above (including indigenous people) with angiographically diagnosed significant CAD in the recent one year were screened for AAA. Standard definition of abdominal aortic aneurysm and CAD was used. All new patients were followed up for six months for AAA events (ruptured AAA and AAA-related mortality). RESULTS A total of 277 male patients were recruited into this study. The total prevalence of undiagnosed AAA in this study population was 1.1% (95% CI 0.2-3.1). In patients with high-risk CAD, the prevalence of undiagnosed AAA was 1.7% (95% CI 0.3-4.8). The detected aneurysms ranged in size from 35.0mm to 63.8mm. Obesity was a common factor in these patients. There were no AAA-related mortality or morbidity during the follow-up. Although the total prevalence of undiagnosed AAA is low in the studied population, the prevalence of sub-aneurysmal aortic dilatation in patients with significant CAD was high at 6.6% (95% CI 3.9-10.2), in which majority were within the younger age group than 65 years old. CONCLUSION This was the first study on the prevalence of undiagnosed AAA in a significant CAD population involving indigenous people in the island of Borneo. Targeted screening of patients with high-risk CAD even though they are younger than 65 years old effectively discover potentially harmful asymptomatic AAA and sub-aneurysmal aortic dilatations.
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Affiliation(s)
- Siong Teng Saw
- Faculty of Medicine, Universiti Kebangsaan Malaysia; Hospital Queen Elizabeth II, Kota Kinabalu, Sabah88300, Malaysia
| | | | - Dayang Anita Abdul Aziz
- Faculty of Medicine, Universiti Kebangsaan Malaysia, UKM Medical Center, Kuala Lumpur56000, Malaysia
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Canchi T, Patnaik SS, Nguyen HN, Ng EYK, Narayanan S, Muluk SC, De Oliveira V, Finol EA. A Comparative Study of Biomechanical and Geometrical Attributes of Abdominal Aortic Aneurysms in the Asian and Caucasian Populations. J Biomech Eng 2020; 142:061003. [PMID: 31633169 PMCID: PMC10782868 DOI: 10.1115/1.4045268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 09/24/2019] [Indexed: 11/08/2022]
Abstract
In this work, we provide a quantitative assessment of the biomechanical and geometric features that characterize abdominal aortic aneurysm (AAA) models generated from 19 Asian and 19 Caucasian diameter-matched AAA patients. 3D patient-specific finite element models were generated and used to compute peak wall stress (PWS), 99th percentile wall stress (99th WS), and spatially averaged wall stress (AWS) for each AAA. In addition, 51 global geometric indices were calculated, which quantify the wall thickness, shape, and curvature of each AAA. The indices were correlated with 99th WS (the only biomechanical metric that exhibited significant association with geometric indices) using Spearman's correlation and subsequently with multivariate linear regression using backward elimination. For the Asian AAA group, 99th WS was highly correlated (R2 = 0.77) with three geometric indices, namely tortuosity, intraluminal thrombus volume, and area-averaged Gaussian curvature. Similarly, 99th WS in the Caucasian AAA group was highly correlated (R2 = 0.87) with six geometric indices, namely maximum AAA diameter, distal neck diameter, diameter-height ratio, minimum wall thickness variance, mode of the wall thickness variance, and area-averaged Gaussian curvature. Significant differences were found between the two groups for ten geometric indices; however, no differences were found for any of their respective biomechanical attributes. Assuming maximum AAA diameter as the most predictive metric for wall stress was found to be imprecise: 24% and 28% accuracy for the Asian and Caucasian groups, respectively. This investigation reveals that geometric indices other than maximum AAA diameter can serve as predictors of wall stress, and potentially for assessment of aneurysm rupture risk, in the Asian and Caucasian AAA populations.
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Affiliation(s)
- Tejas Canchi
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore 639798
| | - Sourav S. Patnaik
- Department of Mechanical Engineering, University of Texas at San Antonio, San Antonio, TX 78249
| | - Hong N. Nguyen
- Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, TX 78249
| | - E. Y. K. Ng
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore 639798
| | - Sriram Narayanan
- The Harley Street Heart and Vascular Centre, Gleneagles Hospital, Singapore 258500
| | - Satish C. Muluk
- Department of Thoracic & Cardiovascular Surgery, Allegheny Health Network, Pittsburgh, PA 15212
| | - Victor De Oliveira
- Department of Management and Statistics, University of Texas at San Antonio, San Antonio, TX 78249
| | - Ender A. Finol
- Department of Mechanical Engineering, University of Texas at San Antonio, One UTSA Circle, EB 3.04.08, San Antonio, TX 78249
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Tsai SH, Hsu LA, Tsai HY, Yeh YH, Lu CY, Chen PC, Wang JC, Chiu YL, Lin CY, Hsu YJ. Aldehyde dehydrogenase 2 protects against abdominal aortic aneurysm formation by reducing reactive oxygen species, vascular inflammation, and apoptosis of vascular smooth muscle cells. FASEB J 2020; 34:9498-9511. [PMID: 32463165 DOI: 10.1096/fj.201902550rrr] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 05/04/2020] [Accepted: 05/07/2020] [Indexed: 12/14/2022]
Abstract
Mitochondrial aldehyde dehydrogenase 2 (ALDH2) is an enzyme that detoxifies aldehydes by converting them to carboxylic acids. ALDH2 deficiency is known to increase oxidative stress. Increased oxidative stress plays a pivotal role in abdominal aortic aneurysm (AAA) pathogenesis. Reactive oxygen species (ROS) promote degradation of the extracellular matrix (ECM) and vascular smooth muscle cell (VSMC) apoptosis. Reducing oxidative stress by an ALDH2 activator could have therapeutic potential for limiting AAA development. We hypothesized that ALDH2 deficiency could increase the risk for AAA by decreasing ROS elimination and that an ALDH2 activator could provide an alternative option for AAA treatment. The National Center for Biotechnology (NCBI) Gene Expression Omnibus (GEO) database was used. Human aortic smooth muscle cells (HASMCs) were used for the in vitro experiments. Gene-targeted ALDH2*2 KI knock-in mice on a C57BL/6J background and apolipoprotein E knockout (ApoE KO) mice were obtained. An animal model of AAA was constructed using osmotic minipumps to deliver 1000 ng/kg/min angiotensin II (AngII) for 28 days. Patients with AAA had significantly lower ALDH2 expression levels than normal subjects. ALDH2*2 KI mice were susceptible to AngII administration, exhibiting significantly increased AAA incidence rates and increased aortic diameters. Alda-1, an ALDH2 activator, reduced AngII-induced ROS production, NF-kB activation, and apoptosis in HASMCs. Alda-1 attenuated AngII-induced aneurysm formation and decreased aortic expansion in ApoE KO mice. We concluded that ALDH2 deficiency is associated with the development of AAAs in humans and a murine disease model. ALDH2 deficiency increases susceptibility to AngII-induced AAA formation by attenuating anti-ROS effects and increasing VSMC apoptosis and vascular inflammation. Alda-1 was shown to attenuate the progression of experimental AAA in a murine model.
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Affiliation(s)
- Shih-Hung Tsai
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department of Physiology and Biophysics, Graduate Institute of Physiology, National Defense Medical Center, Taipei, Taiwan
| | - Lung-An Hsu
- Cardiovascular Department, Chang-Gung Memorial Hospital and School of Medicine, Chang-Gung University, Taoyuan, Taiwan
| | - Hsiao-Ya Tsai
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yung-Hsin Yeh
- Cardiovascular Department, Chang-Gung Memorial Hospital and School of Medicine, Chang-Gung University, Taoyuan, Taiwan
| | - Cheng-Yo Lu
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Po-Chuan Chen
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Jen-Chun Wang
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yi-Lin Chiu
- Department of Biochemistry, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Yuan Lin
- Department of Surgery, Division of Cardiovascular surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Juei Hsu
- Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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Joh JH, Cho S. A Comparison of Aortoiliac Disease between Eastern and Western Countries. Vasc Specialist Int 2019; 35:184-188. [PMID: 31915661 PMCID: PMC6941775 DOI: 10.5758/vsi.2019.35.4.184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 11/24/2019] [Accepted: 12/02/2019] [Indexed: 11/24/2022] Open
Abstract
A variety of diseases are known to develop in the aortoiliac segment; these include abdominal aortic aneurysm (AAA) and aortoiliac occlusive disease. This review summarizes several differences of aortoiliac diseases between eastern and western populations. The prevalence of AAA was higher in western countries (4.57% to 19%) than in eastern countries (0.89% to 4.9%). Greater aortic bifurcation angles were observed in the eastern population, while longer common iliac arteries and aneurysm necks were found in the western population with AAA. However, the angle of the aneurysm was found to be more acute in patients from western countries. Several differences were found between patients from western countries and those from eastern countries regarding the diseases that occur in the aortoiliac segment and their anatomical characteristics. Therefore, different approaches to the treatment of aortoiliac diseases in these two groups should be considered.
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Affiliation(s)
- Jin Hyun Joh
- Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Sungsin Cho
- Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
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Sandiford P, Grey C, Salvetto M, Hill A, Malloy T, Cranefield D, Bramley D. The population prevalence of undetected abdominal aortic aneurysm in New Zealand Māori. J Vasc Surg 2019; 71:1215-1221. [PMID: 31492616 DOI: 10.1016/j.jvs.2019.07.055] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 07/09/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND The prevalence of abdominal aortic aneurysm (AAA) in Polynesian populations such as the New Zealand Māori has not been characterized. We measured this in a large population-based sample. METHODS A cross-sectional population-based prevalence study was conducted as part of an AAA screening pilot; 2467 Māori men aged 54 to 74 years and 1526 women aged 65 to 74 years registered with a primary care practice in Auckland (New Zealand) were invited to be screened by abdominal ultrasound between June 2016 and March 2018. Patients with pre-existing AAA disease and those with terminal conditions or circumstances that would make them unlikely to benefit from screening were excluded. The prevalence rate of AAA in Māori women was calculated with a cutoff definition of 27 mm as well as with the normal 30-mm definition (used in men). A log-binomial regression model estimated the prevalence rate at exactly 65 years for the purpose of comparison with screened populations in the United Kingdom. RESULTS The crude prevalence rate of undiagnosed AAA in Māori men aged 60 to 74 years was 3.6%. In women, it was 1.7% at the 30-mm threshold and 2.3% at 27 mm. The prevalence rate at exactly 65 years of age was calculated from the log-binomial regression model to be 2.7% (confidence interval [CI], 2.0%-3.8%) in men, 0.9% (CI, 0.4%-2.2%) in women at the 30-mm threshold, and 1.5% (CI, 0.7%-3.0%) in women at the 27-mm threshold. Among smokers, the crude prevalence rates were 7.5% (CI, 4.9%-11.5%) in men and 6.9% (CI, 4.1%-11.5%) in women (30 mm+). CONCLUSIONS The prevalence of undiagnosed AAA in New Zealand Māori men is considerably higher than in screened populations of equivalent age in the United Kingdom and Sweden. Prevalence rates in New Zealand Māori women are close to those of screened British men. New Zealand should consider implementing a population-based screening program for Māori men and conduct further research into the health impact of screening Māori women.
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Affiliation(s)
- Peter Sandiford
- Planning Funding and Outcomes Unit, Auckland and Waitemata District Health Boards, Auckland, New Zealand; School of Population Health, University of Auckland, Auckland, New Zealand.
| | - Corina Grey
- Planning Funding and Outcomes Unit, Auckland and Waitemata District Health Boards, Auckland, New Zealand; School of Population Health, University of Auckland, Auckland, New Zealand
| | - Micol Salvetto
- Planning Funding and Outcomes Unit, Auckland and Waitemata District Health Boards, Auckland, New Zealand
| | - Andrew Hill
- Department of Vascular Surgery, Auckland District Health Board, Auckland, New Zealand
| | | | - David Cranefield
- Department of Radiology, Waitemata District Health Board, Auckland, New Zealand
| | - Dale Bramley
- Chief Executive, Waitemata District Health Board, Auckland, New Zealand
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