Risk factors for aortic disease combined with coronary artery disease and the significance of preoperative coronary assessment in endovascular aortic repair
- 1Department of Cardiology, Liaocheng People’s Hospital , ,
- 2Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University , ,
- 3School of Clinical Medicine, Shandong Second Medical University , ,
Abstract
Objective: The clinical utility of preoperative coronary assessment in patients undergoing endovascular aortic repair (EVAR) remains uncertain. This study aims to identify risk factors for aortic disease combined with coronary artery disease (CAD) and evaluate the impact of preoperative coronary assessment on in-hospital adverse events.
Methods: We conducted a single-center retrospective cohort study of patients undergoing elective EVAR at Beijing Anzhen Hospital (January 2021–June 2023). Participants were stratified by coronary assessment status within 12 months pre-surgery. Intergroup comparisons used two-independent samples t -tests and chi-square tests. In-hospital adverse events were a composite endpoint (all-cause mortality, acute myocardial infarction, acute heart failure, stroke, acute kidney injury, bleeding events, endoleak). Univariate logistic regression identified potential risk factors; variables with P < 0.10 were entered into multivariate logistic regression.
Results: A total of 1,139 patients were included, of whom 385 (33.8%) underwent preoperative coronary assessment. Among assessed patients, 278 with CAD received tailored management, including revascularization or optimized medical therapy. CAD risk varied across aortic disease subtypes ( P = 0.005); abdominal aortic aneurysm (AAA) patients had elevated risk ( OR = 2.113, P = 0.027). Age ( OR = 1.036, P = 0.014) and hyperlipidemia ( OR = 2.652, P < 0.001) were independent CAD risk factors. The non-assessment group had higher in-hospital adverse event rates (6.0% vs. 2.6%, P = 0.012), primarily due to major adverse cardiovascular events (MACE) (3.4% vs. 1.3%, P = 0.035). Preoperative assessment was associated with reduced adverse event risk; non-assessed patients had a 277.9% increased risk ( OR = 3.779, P = 0.002).
Conclusion: AAA patients have a substantially elevated risk of concurrent CAD. Comprehensive preoperative coronary evaluation before EVAR optimizes medical management and enables appropriate revascularization, enhancing procedural safety and reducing adverse cardiovascular events.
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BibTeX
@article{lei2026risk,
title = {{Risk factors for aortic disease combined with coronary artery disease and the significance of preoperative coronary assessment in endovascular aortic repair}},
author = {Yuping Lei and Mingduo Zhang and Mengmeng Wang and Xuewen Qi and Yuzeng Xue and Yong Yang and Hang Gao and Zhongzhi Liu and Zebo Xiu},
journal = {Frontiers in cardiovascular medicine},
year = {2026},
month = oct,
doi = {10.3389/fcvm.2026.1967015},
url = {https://europepmc.org/article/PMC/PMC13690516},
note = {CC BY},
}
RIS
TY - JOUR
TI - Risk factors for aortic disease combined with coronary artery disease and the significance of preoperative coronary assessment in endovascular aortic repair
AU - Yuping Lei
AU - Mingduo Zhang
AU - Mengmeng Wang
AU - Xuewen Qi
AU - Yuzeng Xue
AU - Yong Yang
AU - Hang Gao
AU - Zhongzhi Liu
AU - Zebo Xiu
PY - 2026
DA - 2026/10/09
JO - Frontiers in cardiovascular medicine
DO - 10.3389/fcvm.2026.1967015
UR - https://europepmc.org/article/PMC/PMC13690516
AB - Objective: The clinical utility of preoperative coronary assessment in patients undergoing endovascular aortic repair (EVAR) remains uncertain. This study aims to identify risk factors for aortic disease combined with coronary artery disease (CAD) and evaluate the impact of preoperative coronary assessment on in-hospital adverse events. Methods: We conducted a single-center retrospective cohort study of patients undergoing elective EVAR at Beijing Anzhen Hospital (January 2021–June 2023). Participants were stratified by coronary assessment status within 12 months pre-surgery. Intergroup comparisons used two-independent samples t -tests and chi-square tests. In-hospital adverse events were a composite endpoint (all-cause mortality, acute myocardial infarction, acute heart failure, stroke, acute kidney injury, bleeding events, endoleak). Univariate logistic regression identified potential risk factors; variables with P < 0.10 were entered into multivariate logistic regression. Results: A total of 1,139 patients were included, of whom 385 (33.8%) underwent preoperative coronary assessment. Among assessed patients, 278 with CAD received tailored management, including revascularization or optimized medical therapy. CAD risk varied across aortic disease subtypes ( P = 0.005); abdominal aortic aneurysm (AAA) patients had elevated risk ( OR = 2.113, P = 0.027). Age ( OR = 1.036, P = 0.014) and hyperlipidemia ( OR = 2.652, P < 0.001) were independent CAD risk factors. The non-assessment group had higher in-hospital adverse event rates (6.0% vs. 2.6%, P = 0.012), primarily due to major adverse cardiovascular events (MACE) (3.4% vs. 1.3%, P = 0.035). Preoperative assessment was associated with reduced adverse event risk; non-assessed patients had a 277.9% increased risk ( OR = 3.779, P = 0.002). Conclusion: AAA patients have a substantially elevated risk of concurrent CAD. Comprehensive preoperative coronary evaluation before EVAR optimizes medical management and enables appropriate revascularization, enhancing procedural safety and reducing adverse cardiovascular events.
SN - 2297-055X
ER -