Abstract 13277: Abdominal Aortic Aneurysms in the Young: A Case-Control Study
Background: Abdominal aortic aneurysms (AAA) in the young are rare. Previous studies of premature lower extremity atherosclerosis (PLEA) demonstrated frequent severe aorto-iliac occlusive disease (sAID) characteristically occurring within aorto-iliac segment of smaller than expected diameter. No data is available comparing the characteristics of premature AAA (pAAA) to PLEA.
Methods: All pAAA patients were ≤55 years of age at diagnosis and had either AAA>4 cm or AAA repair and were treated at our vascular center during 1998-2010. Complete medical and surgical records were reviewed. Contemporary PLEA patients ≤55 at diagnosis with focal sAID were included for comparison. Associations with pAAA diagnosis (vs PLEA) were evaluated using multivariable logistic regression modeling.
Results: Among 45 pAAA patients (91% male, 20% black, mean age 52±4 years), 43 (96%) had degenerative AAA, and 16 (36%) symptomatic AAA (5-ruptured). Risk factors (RF) included current smoking (78%), hypertension (80%), dyslipidemia (67%), and diabetes mellitus (9%). pAAA patients were compared with 205 PLEA patients (mean age 49±7 years). Multivariable logistic regression analysis showed significant differences between pAAA and PLEA patients (Table) including distinctive demographics, frequencies of familial early atherosclerosis cardiovascular disease (CVD) or malignancies and higher rates of renal insufficiency or cancer in pAAA patients. However, no significant differences in the frequency of traditional RFs were found.
Conclusions: Our findings may suggest different pathological and genetic mechanisms in younger individuals with aneurysmal vs occlusive AID.
- © 2013 by American Heart Association, Inc.