Association Between Diverticular Disease and Abdominal Aortic Aneurysms: Pooled Analysis of Two Population Based Screening Cohorts

Anders Mark-Christensen*, Jes Sanddal Lindholt, Axel Diederichsen, Flemming Hald Steffensen, Martin Busk, Lars Frost, Grazina Urbonaviciene, Jess Lambrechtsen, Kenneth Egstrup, Søren Laurberg

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Background The aetiology of abdominal aortic aneurysms (AAA) is multifactorial, and many risk factors are shared with diverticular disease. It is unknown whether an independent association exists between these conditions. Methods Individuals enrolled in two Danish population based randomised AAA screening trials and assigned to cross sectional screening and evaluation of cardiovascular risk factors were identified. Diagnoses of diverticular disease were interrogated from a national patient registry covering the period from 1977 to the screening date. Adjusted odds ratios (aOR) and hazard ratios (aHR) with 95% CI were calculated as risk measures. Results 24,632 individuals (median age, 69 years) were included. At screening, 687 patients had pre-existing diverticular disease. Patients with diverticular disease were more likely to have AAA at screening compared with those without diverticular disease (5.2% vs. 3.3%) (OR 1.61, 95% CI 1.14–2.27). This association persisted after adjusting for potential confounders (aOR 1.49, 95% CI 1.04–2.12) and on sensitivity analyses. The association was most pronounced for those with a diagnosis of diverticular disease for at least 10 years (aOR 2.56, 95% CI 1.49–4.38). Following screening, 6.2% of patients with diverticular disease and AAA experienced aneurysm rupture, compared with 2.2% of patients with AAA without diverticular disease (aHR 4.1, 95% CI 1.6–10.8). Conclusion An association was found between diverticular disease and AAA in a large population based cohort. Biological causality remains to be established, and a potential impact of diverticular disease on the natural history of AAA needs to be explored further.

Original languageEnglish
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume54
Issue number6
Pages (from-to)772-777
ISSN1078-5884
DOIs
Publication statusPublished - 2017

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Abdominal Aortic Aneurysm
Population
Odds Ratio
Preexisting Condition Coverage
Causality
Registries
Rupture

Keywords

  • Abdominal aortic aneurysm
  • Diverticular disease
  • Diverticulitis
  • Screening

Cite this

@article{7266d992f7a144828e9b42e4e4208681,
title = "Association Between Diverticular Disease and Abdominal Aortic Aneurysms: Pooled Analysis of Two Population Based Screening Cohorts",
abstract = "Background The aetiology of abdominal aortic aneurysms (AAA) is multifactorial, and many risk factors are shared with diverticular disease. It is unknown whether an independent association exists between these conditions. Methods Individuals enrolled in two Danish population based randomised AAA screening trials and assigned to cross sectional screening and evaluation of cardiovascular risk factors were identified. Diagnoses of diverticular disease were interrogated from a national patient registry covering the period from 1977 to the screening date. Adjusted odds ratios (aOR) and hazard ratios (aHR) with 95{\%} CI were calculated as risk measures. Results 24,632 individuals (median age, 69 years) were included. At screening, 687 patients had pre-existing diverticular disease. Patients with diverticular disease were more likely to have AAA at screening compared with those without diverticular disease (5.2{\%} vs. 3.3{\%}) (OR 1.61, 95{\%} CI 1.14–2.27). This association persisted after adjusting for potential confounders (aOR 1.49, 95{\%} CI 1.04–2.12) and on sensitivity analyses. The association was most pronounced for those with a diagnosis of diverticular disease for at least 10 years (aOR 2.56, 95{\%} CI 1.49–4.38). Following screening, 6.2{\%} of patients with diverticular disease and AAA experienced aneurysm rupture, compared with 2.2{\%} of patients with AAA without diverticular disease (aHR 4.1, 95{\%} CI 1.6–10.8). Conclusion An association was found between diverticular disease and AAA in a large population based cohort. Biological causality remains to be established, and a potential impact of diverticular disease on the natural history of AAA needs to be explored further.",
keywords = "Abdominal aortic aneurysm, Diverticular disease, Diverticulitis, Screening",
author = "Anders Mark-Christensen and Lindholt, {Jes Sanddal} and Axel Diederichsen and Steffensen, {Flemming Hald} and Martin Busk and Lars Frost and Grazina Urbonaviciene and Jess Lambrechtsen and Kenneth Egstrup and S{\o}ren Laurberg",
year = "2017",
doi = "10.1016/j.ejvs.2017.10.005",
language = "English",
volume = "54",
pages = "772--777",
journal = "European Journal of Vascular and Endovascular Surgery",
issn = "1078-5884",
publisher = "Elsevier",
number = "6",

}

Association Between Diverticular Disease and Abdominal Aortic Aneurysms : Pooled Analysis of Two Population Based Screening Cohorts. / Mark-Christensen, Anders; Lindholt, Jes Sanddal; Diederichsen, Axel; Steffensen, Flemming Hald; Busk, Martin; Frost, Lars; Urbonaviciene, Grazina; Lambrechtsen, Jess; Egstrup, Kenneth; Laurberg, Søren.

In: European Journal of Vascular and Endovascular Surgery, Vol. 54, No. 6, 2017, p. 772-777.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Association Between Diverticular Disease and Abdominal Aortic Aneurysms

T2 - Pooled Analysis of Two Population Based Screening Cohorts

AU - Mark-Christensen, Anders

AU - Lindholt, Jes Sanddal

AU - Diederichsen, Axel

AU - Steffensen, Flemming Hald

AU - Busk, Martin

AU - Frost, Lars

AU - Urbonaviciene, Grazina

AU - Lambrechtsen, Jess

AU - Egstrup, Kenneth

AU - Laurberg, Søren

PY - 2017

Y1 - 2017

N2 - Background The aetiology of abdominal aortic aneurysms (AAA) is multifactorial, and many risk factors are shared with diverticular disease. It is unknown whether an independent association exists between these conditions. Methods Individuals enrolled in two Danish population based randomised AAA screening trials and assigned to cross sectional screening and evaluation of cardiovascular risk factors were identified. Diagnoses of diverticular disease were interrogated from a national patient registry covering the period from 1977 to the screening date. Adjusted odds ratios (aOR) and hazard ratios (aHR) with 95% CI were calculated as risk measures. Results 24,632 individuals (median age, 69 years) were included. At screening, 687 patients had pre-existing diverticular disease. Patients with diverticular disease were more likely to have AAA at screening compared with those without diverticular disease (5.2% vs. 3.3%) (OR 1.61, 95% CI 1.14–2.27). This association persisted after adjusting for potential confounders (aOR 1.49, 95% CI 1.04–2.12) and on sensitivity analyses. The association was most pronounced for those with a diagnosis of diverticular disease for at least 10 years (aOR 2.56, 95% CI 1.49–4.38). Following screening, 6.2% of patients with diverticular disease and AAA experienced aneurysm rupture, compared with 2.2% of patients with AAA without diverticular disease (aHR 4.1, 95% CI 1.6–10.8). Conclusion An association was found between diverticular disease and AAA in a large population based cohort. Biological causality remains to be established, and a potential impact of diverticular disease on the natural history of AAA needs to be explored further.

AB - Background The aetiology of abdominal aortic aneurysms (AAA) is multifactorial, and many risk factors are shared with diverticular disease. It is unknown whether an independent association exists between these conditions. Methods Individuals enrolled in two Danish population based randomised AAA screening trials and assigned to cross sectional screening and evaluation of cardiovascular risk factors were identified. Diagnoses of diverticular disease were interrogated from a national patient registry covering the period from 1977 to the screening date. Adjusted odds ratios (aOR) and hazard ratios (aHR) with 95% CI were calculated as risk measures. Results 24,632 individuals (median age, 69 years) were included. At screening, 687 patients had pre-existing diverticular disease. Patients with diverticular disease were more likely to have AAA at screening compared with those without diverticular disease (5.2% vs. 3.3%) (OR 1.61, 95% CI 1.14–2.27). This association persisted after adjusting for potential confounders (aOR 1.49, 95% CI 1.04–2.12) and on sensitivity analyses. The association was most pronounced for those with a diagnosis of diverticular disease for at least 10 years (aOR 2.56, 95% CI 1.49–4.38). Following screening, 6.2% of patients with diverticular disease and AAA experienced aneurysm rupture, compared with 2.2% of patients with AAA without diverticular disease (aHR 4.1, 95% CI 1.6–10.8). Conclusion An association was found between diverticular disease and AAA in a large population based cohort. Biological causality remains to be established, and a potential impact of diverticular disease on the natural history of AAA needs to be explored further.

KW - Abdominal aortic aneurysm

KW - Diverticular disease

KW - Diverticulitis

KW - Screening

U2 - 10.1016/j.ejvs.2017.10.005

DO - 10.1016/j.ejvs.2017.10.005

M3 - Journal article

C2 - 29100862

AN - SCOPUS:85033682179

VL - 54

SP - 772

EP - 777

JO - European Journal of Vascular and Endovascular Surgery

JF - European Journal of Vascular and Endovascular Surgery

SN - 1078-5884

IS - 6

ER -