Association of Coronary Artery Disease and Abdominal Aortic Aneurysm – A Narrative Review

Studies have shown a strong association between coronary artery disease (CAD) andAbdominal Aortic Aneurysm (AAA). CAD is an independent predictor for developing AAA. Thestrong risk factors which were associated with the development of AAA were older age,male sex, hypertension, smoking, dyslipidemia, respiratory disease, cerebrovasculardisease, claudication, and renal insuffi ciency in predicting the development of AAA.The prevalence of AAA among patients with angiographyverifi ed CAD was higher in men. Italso increased to 8.6% in men aged above 65 years. They also found that 2.5% of patientswith normal coronary profi le, 4.3% of patients with single vessel disease, 5.7% ofpatients with double vessel disease and 14.4% of patients with triple vessel disease onangiogram had AAA. The Pathological features like chronic infl ammation, degradation ofthe extracellular matrix and apoptosis of the vascular smooth muscle cells are common toboth CAD and AAA. The vascular Smooth Muscle Cell (VSMC) plays an important role in thepathogenesis of coronary artery disease and aortic aneurysms. Another mechanism identified in these VSMCs is the role of ubiquitin-like containing PHD and RING fi nger domains1 (UHRF1) as the epigenetic master regulator of VSMC plasticity. Large symptomatic AAAwith signifi cant CAD, a combined procedure should be the preferred approach.Asymptomatic AAA and CAD, a staged approach of CABG followed by AAA repair within twoweeks should be performed to minimize the risk of AAA rupture. A one-time ultrasoundscreening for AAAs in men or women 65 to 75 years of age with a history of tobacco use,in fi rst-degree relatives of patients who present with an AAA, in men or women olderthan 75 years with a history of tobacco use is recommended.