Aortic aneurysm is an increasingly important public health problem with high morbidity and mortality. It is associated with
coronary artery disease (CAD), which is a comorbidity of high incidence that is reported to worsen perioperative complications and long-term clinical outcomes in patients with an
aortic aneurysm. Patients with significant
coronary artery stenosis may require coronary revascularization and/or optimal medical
therapy in the
perioperative period of
aneurysm surgery. However, the prognostic impact of non-significant
coronary artery stenosis not indicated for coronary revascularization on clinical outcomes of patients with
aortic aneurysms remains unclear. We performed coronary angiography on 239 consecutive patients with thoracic and
abdominal aortic aneurysms before
endovascular aortic repair or surgical repair. The patients were divided into the following 3 groups according to the severity of
stenosis of major coronary arteries: non-CAD group (with < 25%
stenosis), non-significant CAD group (with ≥ 25% but < 75%
stenosis), and significant CAD group (with ≥ 75%
stenosis). CAD was diagnosed in 133 (56%) patients consisting of 48 (20%) patients with non-significant CAD and 85 (36%) patients with significant CAD. Thirty-nine major adverse cardiovascular and cerebrovascular events (MACCEs) occurred in a median follow-up period of 723 days. Kaplan-Meier analysis revealed that the risk of MACCEs was higher in the significant and non-significant CAD groups than in the non-CAD group. Multivariate Cox proportional hazard regression analysis showed that the risk of MACCEs was equally high in the non-significant CAD and significant CAD groups compared to that in the non-CAD group after adjustment for confounding factors. CAD is significantly associated with poor outcomes in patients with
aortic aneurysms, irrespective of the significance of CAD.