Abdominal aortic diameter as a predictor of peripheral atherosclerosis progression in 40-64-year-old patients with cardiovascular risk factors

Aim. To study the prognostic significance of abdominal aorta (AA) diameter in progression of peripheral atherosclerosis in patients aged 40-64 years and without abdominal aortic dilation.

Materials and Methods. The study included 157 outpatients aged 40-64 years who underwent Doppler ultrasonography of brachiocephalic arteries, lower extremity arteries, and abdominal aorta in order to assess cardiovascular risk. Upon the serum collection, we measured lipid fractions, creatinine, glycated hemoglobin, high-sensitivity C-reactive protein, pentraxin-3 and matrix metalloproteinases (MMP-1, MMP-2, MMP-9, and MMP-10). The criteria for the progression of peripheral atherosclerosis were: 1) the appearance of a new atherosclerotic plaque; 2) stenosis increase by ≥ 10%; 3) carotid plaque area increase by ≥ 0.106 cm².

Results. We found that 116 (73.9%) patients initially had low to moderate cardiovascular risk. Abdominal aortic diameter directly correlated with the level of glycated hemoglobin (r = 0.298; p = 0.003) and serum MMP-2 (r = 0.240; p = 0.041), whilst aortic size index directly correlated with serum MMP-9 (r = 0.319; p = 0.029). Repeated Doppler ultrasonography was performed in 120 (76.4%) patients, with the median period between two examinations was 14.4 (12.3; 20.8) months, and progression of peripheral atherosclerosis was identified in 26 (21.6%) patients. An increase in abdominal aortic diameter > 1.64 cm could predict atherosclerosis progression with sensitivity of 53.8% and specificity of 74.1%. According to Cox regression analysis, an increase in abdominal aortic diameter > 1.64 cm was associated with a 2.31-fold increased risk of atherosclerosis progression (95% CI = 1.06 - 5.00, p = 0.034).

Conclusion. Abdominal aortic diameter can be considered as a predictor of peripheral atherosclerosis progression.

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