Abstract 16840: Sudden Death Caused by Ruptured Abdominal Aortic Aneurysm is Highly Related to Left Main Trunk Coronary Stenosis
Background: The sudden death caused by ruptured abdominal aortic aneurysm (RAAA) remains a pending problem. The relevance of coronary artery lesions to sudden death in RAAA patients is also unknown.
Purpose: The aim of this study was to evaluate the coronary stenosis in RAAA patients with sudden death based on the autopsy report in Tokyo district and AAA database in 2 high volume hospitals in Tokyo.
Methods: We conducted a retrospective cohort study of 1423 consecutive patients who underwent surgical repair for infra-renal abdominal aortic aneurysm (AAA) from January 1995 to January 2011. Patient characteristics were evaluated at the time of operation. As for out-of-hospital sudden death due to RAAA, postmortem examination was performed in the Tokyo Medical Examiner’s Office from January 1995 to January 2011. In RAAA patients without sudden death, coronary stenosis was evaluated by coronary angiography (CAG) at stable phase after AAA surgery. All of non-RAAA patients underwent CAG before AAA surgery. Clinical characteristics in RAAA patients with sudden death were compared with those in RAAA patients without sudden death and non-RAAA patients using ANOVA and multiple analyses.
Results: The average age of RAAA patients with sudden death (n=189), RAAA patients without sudden death (n=190) and non-RAAA patients (n=1233) were similar. In RAAA patients with sudden death, co-existence of significant coronary stenosis was significantly more frequent than in RAAA patients without sudden death (47% vs. 13%, p<0.001), but rather less frequent than in non-RAAA patients (47% vs. 59%, p=0.002). In patients with coronary artery disease, significant stenosis of left main trunk (LMT) was remarkably more frequent in RAAA patients with sudden death than RAAA patients without sudden death or non-RAAA patients (45%, 25% and 8%, respectively). The distribution of other coronary stenosis was similar among three groups.
Conclusion: The patients with sudden death caused by RAAA had frequently a LMT coronary stenosis compared to RAAA patients without sudden death or non-RAAA patients.
- © 2013 by American Heart Association, Inc.