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Risk Factors Analysis in Operated Abdominal Aortic Aneurysm Patients

Yıl 2011, Cilt: 14 Sayı: 2, 29 - 33, 01.02.2010

Öz

Background: Abdominal aortic aneurysm is a common disease of the elderly, with a complex etiology. The known risk factors for abdominal aortic aneurysm is age, male gender, presence of family history of AAA, presence of aneurysms elsewhere (especially at the femoral and popliteal artery), smoking, diabetes mellitus, atherosclerosis and hypertension. The aim of this study was to evaluate risk factors associated with operated abdominal aortic aneurysm in our center. Patients and Method: Our study population consisted of 210 patients who had been performed abdominal aortic aneurysm surgery between January 1998 and January 2010 in our clinic. The study was designed in a retrospective manner and all data were collected from hospital records. The patients were searched for diabetes mellitus, hypertension, age, gender, hyperlipidemia, atherosclerosis and smoking. Results: 187 of 210 patients male and 23 of 210 patients female. The mean age was 64,4±8,9. The most common risk factors were diabetes mellitus (10.1%), hypertension (67.6%), hyperlipidemia (30.9%), chronic obstructive pulmonary disease (35.7%) and smoking (76.7%) for abdominal aortic aneurysm. Conclusion: Smoking was found be as the most important risk factor for abdominal aortic aneurysm. To our knowledge, high rate of smoking in our society has a direct link with abdominal aortic aneurysm. The effective implementation of social campaigns to prevent smoking may be promising for reducing the incidence of abdominal aortic aneurysm in our society

Kaynakça

  • Juonston KW, Rutherford RB, Tilson MD, Shah DM, Hollier L, Stanley JC. Suggested standarts for reporting on arterial aneurysms. J Vasc Surg 1991;13:452-8.
  • Haimovici H, Ascer E, Hollier L. Abdominal aortic aneu- rysm. Vasculer Surgery (Fourth Edition) 1996;59:797-827.
  • Ashton HA, Buxton MJ, Day NE, Kım LG, Marteau TM, Scott RA. The Multicentre Aneurysm Screening Study (MASS) into the effect of abdominal aortic aneurysm screen- ing on mortality in men:a randomised controlled trial:Lancet ;360:1531-9.
  • Alcorn HG, Wolfson SK, Sutton-Tyrell K. Risk factors for abdominal aortic aneurysms in older adults enrolled in the Cardiovascular Health Study. Arterioscler Thromb Vasc Biol ;16:963-70. Çörtelekoğlu T.A. Köksal C.Ercan M.Bozkurt A.K.Beşirli K. Tüzün H.Sayın A.G. Abdominal aort etiyolojisinde eser el- ementlerin rolü. TKDCD 2003;11:185-7.
  • Cannon DJ, Read RC. Blood elastolıtic in patients with aortic aneurysm. Ann Thorac Surg 1982;34:10-5.
  • Brophy CM, Reilly JM, Smith GJ. The role of inflamma- tion in non spesific abdominal aortic aneurysm disease. Ann Vasc Surg 1991;5:229-33.
  • Cohen JR, Sarfati I, Donna D, Wise L. Smooth muscle cell elastase, atherosclerosis and abdominal aortic aneurysm. Ann Surg 1992;216:327-30.
  • Steinberg D, Halak M, Shapiro S. Abdominal aortic aneu- rysm and aortic occlusive disease:a comparision of risk fac- tors and inflamatory response. Eur J Vasc Endovasc Surg, ;20:462-5. Forsdahl SH, Kulbir S, Steinar S, Jacobsen BK. Risk factors for abdominal aortic aneurysms:A 7-year pro- spective Study: The Tromso Study 1994-2001. Circulation ;119;2202-8.
  • Vardulaki KA, Walker NM, Day NE, Duffy SW, Ashton HA, Scott RAP. Quantifying the risks of hypertension, age, sex and smoking in patients with abdominal aortic aneurysm. Br J Surg 2000;87:195-200.
  • Lederle FA, Johnson GR, Wilson SE, Chute EP, Littooy FN, Bandyk D. Prevalence and associations of abdominal ab- dominal aortic aneurysm detected through screening. Aneu- rysm Detection and Management (ADAM) Veterans Affairs Cooperative Study Group. Ann Intern Med 1997;126:441-9.
  • Palazzuoli A, Gallotta M, Guerrieri I, Quatrini I, Franci B, Campagna MS, et al. Prevalance of risk factors coronary and systemic atherosclerosis in abdominal aortic aneurysm in comparision with high cardiovascular risk population. Vasc, Health Risk Manag 2008;4;877-83.
  • Hommand EC. Garfinkel L. Coronary heart disease. Stroke and aortic aneurysm. Factors in the etiology. Arch Environ Health 1969;19:167-82.
  • United States Department of Health and Human Serv- ices. The health consequences of smoking:a report of the surgeon general. Atlanta, Ga:Department of Health and Hu- man Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health;2004.
  • Jamrozik K, Norman PE, Spencer CA, Screening for ab- dominal aortic aneurysm:lessons from a population-based study. Med J Aust 2000;173:345-50.
  • Barbara LN, Kim S, Kathleen DS, Anne BN, Lewis HK, Prevalence and Risk Factors for Abdominal Aortic Aneu- rysms in Older Adults with and without Isolated Systolic Hy- pertension. Am J Cardiol 1999;83:759-64.
  • Simoni G, Gianotti A, Ardra A, Bejardi A, Galleano R, Civalleri D. Screening study of abdominal aortic aneurysm in a general population; lipit parameters. J Cardiovasc Surg ;4:445-8. Lee AJ, Fowkes FG, Carson MN, Leng GC, Allan PL, Smoking, atherosclerosis and risk of abdominal aortic aneu- rysm. Eur Heart J 1997;18:671-6.
  • Death AK, Fısher EJ, Mc Grath KC, Yue DK. High glu- cose alters matrix metalloproteinase expression in two key vascular cells: potential impact on atherosclerosis in diabe- tes. Atherosclerosis 2003;168:263-9.
  • Astrand H, Ahılgren AR, Sandgren T, Lanne T. Age- releated increase in wall stres of the human abdominal aorta:an in vivo study. J Vasc Surg 2005;42:926-31.
  • Gollodge J.Norman PE.Diabetes and aortic aneurysm. Am J Cardiol 2008;101:1680-1.
  • Lindholt JS, Heickendorff L, Antonsen S, Fasting H, Hen- neberg EW. Natural History of abdominal aortic aneurysm with and without coexisting chronic obstructive pulmonary disease. J Vasc Surg 1998;28:226-33.
  • Mcmıllan WD, Tamarina NA, Cipolone M, Johnson DA, Parker MA, Pearce WH. Size matters. The Relationship be- tween MMP-9 expression and aortic diamater. Circulation ;96:2228-32.
  • Segura-Valdez L, Pardo A, Gaxiola M, Uhal BD, Beceril C, Selman M. Upregulation of gelatinases A and B, collagenases and 2, and increased parenchmal cell death in COPD. Chest ;117:684-94. Van Laarhoven C, Borstlap A, Van Berge Henegouwen D, Palmen F, Verpalen M, Schoemaker M.Chronic obstructive pul- monary disease and abdominal aortic aneurysms. Eur J Vasc Surg 1993;7:386-90.
  • Carole S, Konrad J, Shane K, Peter B, Paul N. Is there an assocıatıon between chronıc lung disease and abdominal aortic aneurysm expansion? ANZ J Surg 2003;73:787-9.
  • Fleming C, Whitlock EP, Beil TL. Screening for abdomi- nal aortic aneurysm:a best evidence systematic review fort he US Preventive Services Task Force. Ann Intern Med ;142:203-11. Franks PJ, Edwards RJ, Greenhalgh RM. Risk factors for abdominal aortic aneurysms in smokers. Eur J Vasc Endo- vasc Surg 1996;11:487-92.
  • Wilmink TB,Quick CR,Day NE. The association between cigarette smoking and abdominal aortic aneurysm. J Vasc Surg 1999;30:1099-105.
  • Lederle FA, Nelson DB, Joseph AM. Smokers’ relative risk for aortic aneurysm compared with other smoking-related diseases:a systematic review. J Vasc Surg 2003;38:329-34.
  • Michel PB, Batool A, Amy EH, Teri LE, Robert WT, John AC. Cigarette smoking increases aortic dilatation without af- fecting matrix metalloproteinase-9 and -12 expression in a modified Mouse model of aneurysm formation. J Vasc Surg ;45:1217-27.
  • Norman PE, Jamrozık K, Lawrence-Brown MM, Le MT, Spencer CA, Tuohy RJ. Population based randomized con- trolled trial on impact of screening on mortality from abdomi- nal aortic aneurysm. BMJ 2004;329:1259.
  • T.C.Sağlık Bakanlığı Yayınları 2009 (anka ajans).

Opere Abdominal Aort Anevrizmalarında Risk Faktörlerinin İncelenmesi

Yıl 2011, Cilt: 14 Sayı: 2, 29 - 33, 01.02.2010

Öz

Amaç: Abdominal aort anevrizması yaşlılarda sık görülen kompleks etyolojisi olan bir hastalıktır. Abdominal aort anevrizması (AAA) için bilinen risk faktörleri yaş, erkek cinsiyet, ailede AAA varlığı, vücüdun başka bir yerindeki arteryel anevrizmalar (özellikle femoral ve popliteal arter), sigara, diabetes mellitus, ateroskleroz ve hipertansiyondur. Çalışmamızda kliniğimizde opere edilen 210 vakayı retrospektif tarayarak, literatür eşliğinde ülkemizdeki risk faktörlerini incelemeyi amaçladık. Hastalar ve Metod: Ocak 1998 - Ocak 2010 tarihleri arasında tedavi edilen cerrahi sınırlardaki abdominal aort anevrizmalı 210 hasta çalışmaya dahil edildi ve hastane kayıtları retrospektif olarak incelendi. Hastalar yaş, cinsiyet, hipertansiyon, kronik obstriktif akciğer hastalığı, ateroskleroz, diabet ve sigara tüketimi yönünden araştırıldı. Bulgular: Operasyona alınan 210 hastanın 187'si erkek, 23'ü kadın olup ortalama yaş 64,4±8,9 idi. En sık eşlik eden risk faktörleri sigara kullanımı (%76,7), hipertansiyon (%67.6), kronik obstrüktif akciğer hastalığı (KOAH) (%35,7), hiperkolesterolemi (%30.9), diabetes mellitus (%10.1) idi. Sonuç: Çalışma grubumuzda sigara içimi en önemli risk faktörü olarak tespit edildi. Toplumumuzda sigara içim oranının yüksek olmasının, AAA sıklığını arttırdığını düşünüyoruz. Sigara içimini önlemeye yönelik toplumsal kampanyaların etkin şekilde uygulanması AAA sıklığını azaltmada umut vericidir.

Kaynakça

  • Juonston KW, Rutherford RB, Tilson MD, Shah DM, Hollier L, Stanley JC. Suggested standarts for reporting on arterial aneurysms. J Vasc Surg 1991;13:452-8.
  • Haimovici H, Ascer E, Hollier L. Abdominal aortic aneu- rysm. Vasculer Surgery (Fourth Edition) 1996;59:797-827.
  • Ashton HA, Buxton MJ, Day NE, Kım LG, Marteau TM, Scott RA. The Multicentre Aneurysm Screening Study (MASS) into the effect of abdominal aortic aneurysm screen- ing on mortality in men:a randomised controlled trial:Lancet ;360:1531-9.
  • Alcorn HG, Wolfson SK, Sutton-Tyrell K. Risk factors for abdominal aortic aneurysms in older adults enrolled in the Cardiovascular Health Study. Arterioscler Thromb Vasc Biol ;16:963-70. Çörtelekoğlu T.A. Köksal C.Ercan M.Bozkurt A.K.Beşirli K. Tüzün H.Sayın A.G. Abdominal aort etiyolojisinde eser el- ementlerin rolü. TKDCD 2003;11:185-7.
  • Cannon DJ, Read RC. Blood elastolıtic in patients with aortic aneurysm. Ann Thorac Surg 1982;34:10-5.
  • Brophy CM, Reilly JM, Smith GJ. The role of inflamma- tion in non spesific abdominal aortic aneurysm disease. Ann Vasc Surg 1991;5:229-33.
  • Cohen JR, Sarfati I, Donna D, Wise L. Smooth muscle cell elastase, atherosclerosis and abdominal aortic aneurysm. Ann Surg 1992;216:327-30.
  • Steinberg D, Halak M, Shapiro S. Abdominal aortic aneu- rysm and aortic occlusive disease:a comparision of risk fac- tors and inflamatory response. Eur J Vasc Endovasc Surg, ;20:462-5. Forsdahl SH, Kulbir S, Steinar S, Jacobsen BK. Risk factors for abdominal aortic aneurysms:A 7-year pro- spective Study: The Tromso Study 1994-2001. Circulation ;119;2202-8.
  • Vardulaki KA, Walker NM, Day NE, Duffy SW, Ashton HA, Scott RAP. Quantifying the risks of hypertension, age, sex and smoking in patients with abdominal aortic aneurysm. Br J Surg 2000;87:195-200.
  • Lederle FA, Johnson GR, Wilson SE, Chute EP, Littooy FN, Bandyk D. Prevalence and associations of abdominal ab- dominal aortic aneurysm detected through screening. Aneu- rysm Detection and Management (ADAM) Veterans Affairs Cooperative Study Group. Ann Intern Med 1997;126:441-9.
  • Palazzuoli A, Gallotta M, Guerrieri I, Quatrini I, Franci B, Campagna MS, et al. Prevalance of risk factors coronary and systemic atherosclerosis in abdominal aortic aneurysm in comparision with high cardiovascular risk population. Vasc, Health Risk Manag 2008;4;877-83.
  • Hommand EC. Garfinkel L. Coronary heart disease. Stroke and aortic aneurysm. Factors in the etiology. Arch Environ Health 1969;19:167-82.
  • United States Department of Health and Human Serv- ices. The health consequences of smoking:a report of the surgeon general. Atlanta, Ga:Department of Health and Hu- man Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health;2004.
  • Jamrozik K, Norman PE, Spencer CA, Screening for ab- dominal aortic aneurysm:lessons from a population-based study. Med J Aust 2000;173:345-50.
  • Barbara LN, Kim S, Kathleen DS, Anne BN, Lewis HK, Prevalence and Risk Factors for Abdominal Aortic Aneu- rysms in Older Adults with and without Isolated Systolic Hy- pertension. Am J Cardiol 1999;83:759-64.
  • Simoni G, Gianotti A, Ardra A, Bejardi A, Galleano R, Civalleri D. Screening study of abdominal aortic aneurysm in a general population; lipit parameters. J Cardiovasc Surg ;4:445-8. Lee AJ, Fowkes FG, Carson MN, Leng GC, Allan PL, Smoking, atherosclerosis and risk of abdominal aortic aneu- rysm. Eur Heart J 1997;18:671-6.
  • Death AK, Fısher EJ, Mc Grath KC, Yue DK. High glu- cose alters matrix metalloproteinase expression in two key vascular cells: potential impact on atherosclerosis in diabe- tes. Atherosclerosis 2003;168:263-9.
  • Astrand H, Ahılgren AR, Sandgren T, Lanne T. Age- releated increase in wall stres of the human abdominal aorta:an in vivo study. J Vasc Surg 2005;42:926-31.
  • Gollodge J.Norman PE.Diabetes and aortic aneurysm. Am J Cardiol 2008;101:1680-1.
  • Lindholt JS, Heickendorff L, Antonsen S, Fasting H, Hen- neberg EW. Natural History of abdominal aortic aneurysm with and without coexisting chronic obstructive pulmonary disease. J Vasc Surg 1998;28:226-33.
  • Mcmıllan WD, Tamarina NA, Cipolone M, Johnson DA, Parker MA, Pearce WH. Size matters. The Relationship be- tween MMP-9 expression and aortic diamater. Circulation ;96:2228-32.
  • Segura-Valdez L, Pardo A, Gaxiola M, Uhal BD, Beceril C, Selman M. Upregulation of gelatinases A and B, collagenases and 2, and increased parenchmal cell death in COPD. Chest ;117:684-94. Van Laarhoven C, Borstlap A, Van Berge Henegouwen D, Palmen F, Verpalen M, Schoemaker M.Chronic obstructive pul- monary disease and abdominal aortic aneurysms. Eur J Vasc Surg 1993;7:386-90.
  • Carole S, Konrad J, Shane K, Peter B, Paul N. Is there an assocıatıon between chronıc lung disease and abdominal aortic aneurysm expansion? ANZ J Surg 2003;73:787-9.
  • Fleming C, Whitlock EP, Beil TL. Screening for abdomi- nal aortic aneurysm:a best evidence systematic review fort he US Preventive Services Task Force. Ann Intern Med ;142:203-11. Franks PJ, Edwards RJ, Greenhalgh RM. Risk factors for abdominal aortic aneurysms in smokers. Eur J Vasc Endo- vasc Surg 1996;11:487-92.
  • Wilmink TB,Quick CR,Day NE. The association between cigarette smoking and abdominal aortic aneurysm. J Vasc Surg 1999;30:1099-105.
  • Lederle FA, Nelson DB, Joseph AM. Smokers’ relative risk for aortic aneurysm compared with other smoking-related diseases:a systematic review. J Vasc Surg 2003;38:329-34.
  • Michel PB, Batool A, Amy EH, Teri LE, Robert WT, John AC. Cigarette smoking increases aortic dilatation without af- fecting matrix metalloproteinase-9 and -12 expression in a modified Mouse model of aneurysm formation. J Vasc Surg ;45:1217-27.
  • Norman PE, Jamrozık K, Lawrence-Brown MM, Le MT, Spencer CA, Tuohy RJ. Population based randomized con- trolled trial on impact of screening on mortality from abdomi- nal aortic aneurysm. BMJ 2004;329:1259.
  • T.C.Sağlık Bakanlığı Yayınları 2009 (anka ajans).
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Orhan Fındık Bu kişi benim

Ali Fedakar Bu kişi benim

İbrahim Kara Bu kişi benim

Özgür Kocamaz Bu kişi benim

Cantürk Çakalağaoğlu Bu kişi benim

Cengiz Köksal Bu kişi benim

Hasan Sunar Bu kişi benim

Yayımlanma Tarihi 1 Şubat 2010
Yayımlandığı Sayı Yıl 2011 Cilt: 14 Sayı: 2

Kaynak Göster

APA Fındık, O. ., Fedakar, A. ., Kara, İ. ., Kocamaz, Ö. ., vd. (2010). Opere Abdominal Aort Anevrizmalarında Risk Faktörlerinin İncelenmesi. Koşuyolu Kalp Dergisi, 14(2), 29-33.
AMA Fındık O, Fedakar A, Kara İ, Kocamaz Ö, Çakalağaoğlu C, Köksal C, Sunar H. Opere Abdominal Aort Anevrizmalarında Risk Faktörlerinin İncelenmesi. Koşuyolu Kalp Dergisi. Şubat 2010;14(2):29-33.
Chicago Fındık, Orhan, Ali Fedakar, İbrahim Kara, Özgür Kocamaz, Cantürk Çakalağaoğlu, Cengiz Köksal, ve Hasan Sunar. “Opere Abdominal Aort Anevrizmalarında Risk Faktörlerinin İncelenmesi”. Koşuyolu Kalp Dergisi 14, sy. 2 (Şubat 2010): 29-33.
EndNote Fındık O, Fedakar A, Kara İ, Kocamaz Ö, Çakalağaoğlu C, Köksal C, Sunar H (01 Şubat 2010) Opere Abdominal Aort Anevrizmalarında Risk Faktörlerinin İncelenmesi. Koşuyolu Kalp Dergisi 14 2 29–33.
IEEE O. . Fındık, A. . Fedakar, İ. . Kara, Ö. . Kocamaz, C. . Çakalağaoğlu, C. . Köksal, ve H. . Sunar, “Opere Abdominal Aort Anevrizmalarında Risk Faktörlerinin İncelenmesi”, Koşuyolu Kalp Dergisi, c. 14, sy. 2, ss. 29–33, 2010.
ISNAD Fındık, Orhan vd. “Opere Abdominal Aort Anevrizmalarında Risk Faktörlerinin İncelenmesi”. Koşuyolu Kalp Dergisi 14/2 (Şubat 2010), 29-33.
JAMA Fındık O, Fedakar A, Kara İ, Kocamaz Ö, Çakalağaoğlu C, Köksal C, Sunar H. Opere Abdominal Aort Anevrizmalarında Risk Faktörlerinin İncelenmesi. Koşuyolu Kalp Dergisi. 2010;14:29–33.
MLA Fındık, Orhan vd. “Opere Abdominal Aort Anevrizmalarında Risk Faktörlerinin İncelenmesi”. Koşuyolu Kalp Dergisi, c. 14, sy. 2, 2010, ss. 29-33.
Vancouver Fındık O, Fedakar A, Kara İ, Kocamaz Ö, Çakalağaoğlu C, Köksal C, Sunar H. Opere Abdominal Aort Anevrizmalarında Risk Faktörlerinin İncelenmesi. Koşuyolu Kalp Dergisi. 2010;14(2):29-33.