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Journal Information
Vol. 36. Issue 4.
Pages 218-226 (July - August 2024)
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Vol. 36. Issue 4.
Pages 218-226 (July - August 2024)
Original article
Ultrasound screening for abdominal aortic aneurysm in primary care
Utilidad de la ecografía en el cribado del aneurisma de aorta abdominal en atención primaria
Antonio López-Télleza, José Manuel Ramírez Torresa, Estrella Pérez Vázquezb, Miguel Ángel Babiano Fernándezc, Helena López-Martíd, Irene Zapata Martíneze,
Corresponding author
irenezapata365@hotmail.com

Corresponding author.
, Cristóbal Trillo Fernándeza, Manuel Frías Vargasf,g, María Dolores Domínguez Pinosh, Juan Fernando Peiró Moranti, José Antonio González-Fajardoj, Pedro Valdivielso Felicesk, on behalf of the SEMERGEN Working Group on Vasculopathies
a Centro de Salud Puerta Blanca, Málaga, Spain
b Centro de Salud Vielha, Consultorio local Naut Aran, Lleida, Spain
c Centro de Salud Argamasilla de Calatrava, Ciudad Real, Spain
d Facultad de Medicina, Universidad de Córdoba, Córdoba, Spain
e Medicina de Familia, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
f Centro de Salud San Andrés, Madrid, Spain
g Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
h Servicio de Radiodiagnóstico, Hospital Universitario Virgen de la Victoria, Málaga, Spain
i Centro de Salud Ponent, Balearic Islands, Spain
j Servicio de Cirugía Vascular, Hospital Universitario 12 de Octubre, Madrid, Spain
k Servicio de Medicina Interna, Hospital Universitario Virgen de la Victoria, Málaga, Spain
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Statistics
Tables (3)
Table 1. Characteristics of the study population.
Table 2. analytical data overall and according to the presence or absence of AAA.
Table 3. Multivariate analysis by logistic regression.
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Abstract
Introduction

Abdominal aortic aneurysm (AAA) constitutes a pathology with high mortality. There is currently no screening program implemented in Primary care in Spain.

Objectives

To evaluate the usefulness of ultrasound in the detection of AAA in the at-risk population in Primary care. Secondarily, to identify subjects whose vascular risk (VR) should be reclassified and to determine whether AAA is associated with the presence of carotid plaque and other risk factors.

Material and methods

Cross-sectional, descriptive, multicenter, national, descriptive study in Primary care. Subjects: A consecutive selection of hypertensive males aged between 65 and 75 who are either smokers or former smokers, or individuals over the age of 50 of both sexes with a family history of AAA.

Measurements

Diameter of abdominal aorta and iliac arteries; detection of abdominal aortic and carotid atherosclerotic plaque. VR was calculated at the beginning and after testing (SCORE).

Results

150 patients were analyzed (age: 68.3 ± 5 years; 89.3% male). Baseline RV was high/very high in 55.3%. AAA was detected in 12 patients (8%; 95%CI: 4–12); aortic ectasia in 13 (8.7%); abdominal aortic plaque in 44% and carotid plaque in 62% of the participants. VR was reclassified in 50% of subjects. The detection of AAA or ectasia was associated with the presence of carotid plaque, current smoking and lipoprotein(a), p < 0.01.

Conclusions

The prevalence of AAA in patients with VR is high. Ultrasound in Primary care allows detection of AAA and subclinical atherosclerosis and consequently reclassification of the VR, demonstrating its utility in screening for AAA in the at-risk population.

Keywords:
Abdominal aortic aneurysm
Subclinical atherosclerosis
Primary care
Resumen
Introducción

El aneurisma de aorta abdominal (AAA) constituye una patología de alta mortalidad. En España, en Atención Primaria, no hay programa de cribado implantado actualmente.

Objetivos

Evaluar la utilidad de la ecografía en la detección del AAA en población de riesgo en Atención Primaria. Secundariamente, identificar sujetos cuyo riesgo vascular (RV) debe reclasificarse y determinar si el AAA se asocia a la presencia de placa carotídea y otros factores de riesgo.

Material y métodos

Estudio descriptivo transversal, multicéntrico nacional en Atención Primaria.

Sujetos

Selección consecutiva de varones hipertensos entre 65-75 años, fumadores o exfumadores; o mayores de 50 años de ambos sexos con antecedentes familiares de AAA. Mediciones: Diámetro de aorta abdominal y arterías ilíacas; detección de placa aterosclerótica aórtica abdominal y carotídea. Se calculó el RV inicialmente y tras las pruebas (SCORE).

Resultados

Se analizaron 150 pacientes (edad: 68,3 ± 5 años; 89,3% varones). El RV inicial era alto/muy alto en el 55,3%. Se detectó AAA en 12 pacientes (8%; IC95%:4-12); ectasia aórtica en 13 (8,7%); placa aórtica abdominal en el 44% y placa carotídea en el 62% de los participantes. Se reclasificó el RV en el 50% de los sujetos. La detección de AAA o ectasia se asociaron a la presencia de placa carotídea, tabaquismo actual y lipoproteína(a), p < 0,01.

Conclusiones

La prevalencia de AAA en pacientes con RV es elevada. La ecografía en Atención Primaria permite detectar AAA y aterosclerosis subclínica y consecuentemente reclasificar el RV, demostrando su utilidad en el cribado de AAA en población de riesgo.

Palabras clave:
Aneurisma de aorta abdominal
Aterosclerosis subclínica
Atención Primaria

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