Document Detail


Natural history of abdominal aortic aneurysm with and without coexisting chronic obstructive pulmonary disease.
MedLine Citation:
PMID:  9719317     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To study the relation between abdominal aortic aneurysms and chronical obstructive pulmonary disease (COPD), in particular the suggested common elastin degradation caused by elastase and smoking.
METHODS: A cross-sectional population study and a prospective cohort study of small abdominal aortic aneurysms was performed in a community setting. All previous diagnoses recorded in a hospital computer database were received for 4404 men 65 to 73 years of age who had been invited to a population screening for abdominal aortic aneurysm. One hundred forty-one men had AAA (4.2%). They were asked to participate in an interview, a clinical examination, and collection of blood sample. Men with an abdominal aortic aneurysm 3 to 5 cm in diameter were offered annual ultrasound scans to check for expansion.
RESULTS: Among patients with COPD 7.7% had abdominal aortic aneurysms (crude odds ratio=2.05). The adjusted odds ratio, however, was only 1.59 after adjustment for coexisting diseases associated with abdominal aortic aneurysm (P=.13). The mean annual expansion was 2.74 mm per year among patients with COPD, 2.72 among patients without COPD, and 4.7 mm among patients who used oral steroids compared with 2.6 among patients who did not use steroids (P < .05). Concentration of serum elastin peptide and plasma elastase-alpha1-antitrypsin complexes correlated negatively with forced expiratory volume in the first second (FEV1) among patients with COPD. However, multivariate regression analysis showed that concentration of serum elastin peptide, therapy with beta-agonists, and FEV1 correlated positively with degree of expansion but that concentration of plasma elastase-alpha1-antitrypsin complexes and serum alpha1-antitrypsin did not influence expansion, suggesting that elastase plays an important role in the pathogenesis of COPD but not of abdominal aortic aneurysm.
CONCLUSION: The high prevalence of abdominal aortic aneurysm among patients with COPD is more likely to be caused by medication and coexisting diseases rather than a common pathway of pathogenesis.
Authors:
J S Lindholt; L Heickendorff; S Antonsen; H Fasting; E W Henneberg
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  28     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  1998 Aug 
Date Detail:
Created Date:  1998-09-02     Completed Date:  1998-09-02     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  226-33     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, Viborg Hospital, Denmark.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anti-Inflammatory Agents / administration & dosage,  adverse effects
Aortic Aneurysm, Abdominal / complications*,  epidemiology,  etiology
Causality
Cohort Studies
Comorbidity
Cross-Sectional Studies
Denmark / epidemiology
Forced Expiratory Volume / physiology
Humans
Incidence
Leukocyte Elastase / metabolism
Lung Diseases, Obstructive / complications*,  epidemiology,  etiology
Male
Odds Ratio
Pancreatic Elastase / blood
Prospective Studies
Risk Factors
Smoking / adverse effects
Steroids
alpha 1-Antitrypsin / metabolism
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Steroids; 0/alpha 1-Antitrypsin; 0/alpha 1-antitrypsin-leukocyte elastase complex; EC 3.4.21.36/Pancreatic Elastase; EC 3.4.21.37/Leukocyte Elastase

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