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Risk factors and incidence of coronary artery lesions in patients with abdominal aortic aneurysms.

We determined the incidence of coronary lesions by coronary angiography and the associated risk factors in 102 patients with abdominal aortic aneurysms (AAA). Old myocardial infarction was observed in 33 patients and angina pectoris in 27 patients. Coronary angiography revealed significant stenosis (> or = 75%) in 66 patients, including single-vessel disease in 22 patients and multiple-vessel disease in 44 patients. Angiography detected 21 coronary artery ectasia lesions, consisting of 10 saccular and 11 fusiform aneurysms in 18 patients. Significant coronary stenosis was present in approximately two-thirds of patients with AAA, suggesting that coronary angiography is a useful preoperative examination in patients with AAA. The incidence of coronary ectasia was also high in patients with this disease, perhaps because AAA and coronary ectasia involve similar pathogenic processes. There was considerable overlap in risk factors in patients with AAA and patients with coronary artery disease without AAA. However, advanced age and hypertension were more strongly associated with AAA than with coronary artery disease.