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Prevalence and Prediction of Aneurysmal Dilatation of the Abdominal Aorta in Koreans: Results of Screening During Transthoracic Echocardiographic Examination

Journal of Cardiovascular Imaging 2020년 28권 4호 p.257 ~ 264
안수연, 황원묵, 선병주, 박재형,
소속 상세정보
안수연 ( An Soo-Yeon ) - Chungnam National University College of Medicine Chungnam National University Hospital Department of Internal Medicine
황원묵 ( Hwang Won-Mook ) - Chungnam National University College of Medicine Chungnam National University Hospital Department of Internal Medicine
선병주 ( Sun Byung-Joo ) - Chungnam National University College of Medicine Chungnam National University Hospital Department of Internal Medicine
박재형 ( Park Jae-Hyeong ) - Chungnam National University College of Medicine Chungnam National University Hospital Department of Internal Medicine

Abstract


BACKGROUND: Aortic aneurysm (AA) is an enlargement of the aorta to greater than 1.5 times normal size. Although the US guideline recommends ultrasound screening for abdominal AA (AAA) in men older than 65 years regardless of symptoms, limited data describe the prevalence of AAA in Korea. In this study, we screened patients for AAA during transthoracic echocardiographic examination (TTE).

METHODS: We screened for AAA in all consecutive subjects older than 60 years who underwent TTE. We defined AAA as an abdominal aorta with the diameter greater than 30 mm.

RESULTS: We analyzed 5,679 persons (2,272 females, 74 ± 8 years old). The mean size of the abdominal aorta was 19.0 ± 6.1 mm. The prevalence of AAA was 2.9% (165/5,679) and was significantly higher in males (4.7% vs. 1.1%, p < 0.001). AAA was significantly associated with male sex (odds ratio [OR] = 3.098, 95% confidence interval [CI] = 1.971-4.870, p < 0.001), older age (OR = 1.074, 95% CI = 1.050-1.097, p < 0.001), non-diabetes (OR = 1.886, 95% CI = 1.264-2.813, p < 0.001), dyslipidemia (OR = 1.475, 95% CI = 1.019-2.135, p = 0.040), ever-smoker (OR = 2.090, 95% CI = 1.448-3.015, p < 0.001), chronic kidney disease (CKD, OR = 1.757, 95% CI = 1.182-2.612, p = 0.005), and coronary artery disease (CAD, OR = 2.452, 95% CI = 1.742-3.451, p < 0.001). A prediction score with a multivariate model (range: 3.34-10.51) detected AAA with a sensitivity of 79.4% and a specificity of 66.8% with a reference value > 6.8 (area under the curve = 0.799).

CONCLUSIONS: In Korea, the prevalence of AAA was 2.9% in subjects older than 60 years during TTE, and AAA was significantly associated with older age, male sex, non-diabetes, dyslipidemia, ever-smoker, CKD, and CAD. Prediction score (> 6.8%) detected AAA with a sensitivity of 79.4% and a specificity of 66.8%.

키워드

Abdominal aortic aneurysm; Echocardiography; Mass screening

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