Screening for abdominal aortic aneurysm in patients with clinically manifest vascular disease
| Autor: | Hendrik M. Nathoe, Frank L.J. Visseren, Joost A. van Herwaarden, Ynte M. Ruigrok, Annemarijn R. de Boer, Ilonca Vaartjes, Michiel L. Bots, Ineke van Dis |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Epidemiology Age adjustment 030204 cardiovascular system & hematology 030230 surgery Cohort Studies 03 medical and health sciences Sex Factors 0302 clinical medicine Risk Factors Interquartile range Internal medicine Prevalence Humans Mass Screening Medicine In patient Prospective Studies Aged Ultrasonography medicine.diagnostic_test business.industry Vascular disease medicine.disease Abdominal aortic aneurysm Confidence interval Abdominal ultrasonography Female Cardiology and Cardiovascular Medicine business Aortic Aneurysm Abdominal Cohort study |
| Zdroj: | European Journal of Preventive Cardiology. 29:1170-1176 |
| ISSN: | 2047-4881 2047-4873 |
| Popis: | Aims Declining prevalence of abdominal aortic aneurysm (AAA) might force a more targeted screening approach (high-risk populations only) in order to maintain (cost-)effectiveness. We aimed to determine temporal changes in the prevalence of screening-detected AAA, to assess AAA-related surgery, and evaluate all-cause mortality in patients with manifest vascular disease. Methods and results We included patients with manifest vascular disease but without a history of AAA enrolled in the ongoing single-centre prospective UCC-SMART cohort study. Patients were screened at baseline for AAA by abdominal ultrasonography. We calculated sex- and age-specific prevalence of AAA, probability of survival in relation to the presence of AAA, and the proportion of patients undergoing AAA-related surgery. Prevalence of screening-detected AAA in 5440 screened men was 2.5% [95% confidence interval (CI) 2.1–2.9%] and in 1983 screened women 0.7% (95% CI 0.4–1.1%). Prevalence declined from 1997 until 2017 in men aged 70–79 years from 8.1% to 3.2% and in men aged 60–69 years from 5.7% to 1.0%. 36% of patients with screening-detected AAA received elective AAA-related surgery during follow-up (median time until surgery = 5.3 years, interquartile range 2.5–9.1). Patients with screening-detected AAA had a lower probability of survival (sex and age adjusted) compared to patients without screening-detected AAA (51%, 95% CI 41–64% vs. 69%, 95% CI 68–71%) after 15 years of follow-up. Conclusion The prevalence of screening-detected AAA has declined over the period 1997–2017 in men with vascular disease but exceeds prevalence in already established screening programs targeting 65-year-old men. Screening for AAA in patients with vascular disease may be cost-effective, but this remains to be determined. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|