Autor:in:
Dr. Egan Kalmykov | Uniklinik Köln | Germany
Introduction. The patients with abdominal aortic aneurysm (AAA) have a number of comorbidities and risk factors that significantly affect the results of treatment and survival. In addition, number of comorbidities affects not only the status of patients, but might also be a risk factor for development and progression of AAA. However, there are limited data on the prevalence of demographics, comorbidities, and risk factors in patients with abdominal aorta aneurysm in different geographical regions.
The aim of the study. To compare the demographics, comorbidities and risk factors in patients with abdominal aortic aneurysm in Cologne (Germany), Dushanbe (Tajikistan) and Ryazan (Russia).
Materials and methods. A comparative retrospective study including patients, with infrarenal AAA who were treated in vascular centers in Germany, Tajikistan and Russia is performed. There were a total number of 711 patients, 499 from Cologne, 46 from Dushanbe and 166 from Ryazan.
Results. The male/ female ratio was 69,3% /30,7% in Cologne, 72% / 28% in Dushanbe and in Ryazan 78,3% / 36 21,7% respectively (*p .867, **p .029, ***p .429). In these three regions the age of patients was significantly different, in Cologne (median, IQR) 73 [67;79], in Dushanbe 65 [63;68] and 68 [62;76] years (*p .000, **p .000, ***p .036). Also patient in Cologne were taller – 1,75 [1,70;1,80], in Dushanbe 1,72 [1,68;1,76] and in Ryazan 1,72 [1,68;1,76] cm (*p 0,014, **p 0,000, ***p 0.974). The weight was greater in patient from Cologne 80 [72;92], in Dushanbe 76 [70;81] and in Ryazan 78 [70;86] (*p .024, **p .015, ***p .015).
The AAA diameter was greater in patient from Ryazan. The AAA diameter in patient from Cologne was 54 [50;61] vs Dushanbe 58 [54;63] and 60 [48;75] from Ryazan respectively (*p .003, **p .000 and ***p .744). More over in Ryazan and Dushanbe the rate of AAA rupture was greater as this in Cologne with 10% in Cologne, 28,2% in Dushanbe and in Ryazan 49 (29,5%) patients (*p .001, **p .000, ***p .513).
17% of patients in Cologne had diabetes vs 24% and 6,2% in in Dushanbe and Ryazan respectively (*p .311, **p .000 and *** p .001). There was a similar percentage of smokers in Cologne 33%, in Dushanbe 33% and in Ryazan 19%, the significant difference were between Cologne and Ryazan (P= .001).
The prevalence of CAD was higher in Russia. In Cologne/Dushanbe/Ryazan were 24%/ 61% / 77% of patients respectively (*p .000, **p .000, *** p .035). Arterial hypertension has a prevalence of 68% / 95% / 80,1% respectively (*p .000, **p .019, *** p .012). Prevalence of COPD in 18,4%/ 39% / 20% of patients (*p .002, **p .733, *** p .011).
Among patients from these three different regions, the frequency medication’s use was also significantly different. 58,1% of patients in cologne had got ß-blockers vs 26% and 18,6% in Dushanbe and Ryazan respectively (*p .000, **p .163, *** p .175). 56,5% had got statin vs 30% and 42% (*p .000/**p .000, ***p .175), Aspirin was a standard medication in 67% /30% / 52% of patients from Cologne, Dushanbe and Ryazan (*p .000, **p .000, ***p .012).
CONCLUSION. The prevalence of comorbidities, risk factors and medical treatment among patients with infrarenal abdominal aortic aneurysm is not the same in different geographical regions.
*p-difference Cologne vs Dushanbe
**p-difference Cologne vs Ryazan and
***p-difference Dushanbe vs Ryazan.