Utilidad de la ecografía en el cribado del aneurisma de aorta abdominal en atención primaria.

Abstract

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 inPrimary care. Subjects: A consecutive selection of hypertensive males aged between 65 and 75who are either smokers or former smokers, or individuals over the age of 50 of both sexes witha family history of AAA.Measurements: Diameter of abdominal aorta and iliac arteries; detection of abdominal aor-tic 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 washigh/very high in 55.3%. AAA was detected in 12 patients (8%; 95%CI: 4---12); aortic ectasiain 13 (8.7%); abdominal aortic plaque in 44% and carotid plaque in 62% of the participants. VRwas reclassified in 50% of subjects. The detection of AAA or ectasia was associated with thepresence 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 careallows detection of AAA and subclinical atherosclerosis and consequently reclassification of theVR, demonstrating its utility in screening for AAA in the at-risk population.