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This epidemiological change is probably related to reduced tobacco consumption&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">1&#44;2</span></a> AAA rupture is responsible for 1&#8211;2&#37; of all deaths in men aged 65 to 85 years in developed countries&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">3&#8211;6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The risk factors most related to the development of AAA are tobacco use&#44; advanced age&#44; male sex&#44; arterial hypertension &#40;AHT&#41;&#44; hypercholesterolemia and a family history of AAA&#46; In contrast&#44; diabetes mellitus has been related to a lower risk of developing AAA&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">7&#44;8</span></a> There are other factors&#44; such as hereditary connective tissue diseases &#40;Marfan syndrome and Ehlers&#8211;Danlos syndrome&#41;&#44; tuberous sclerosis and vasculitis&#44; which are less common and are associated with AAA in young patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">1&#44;9</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">A number of countries recommend AAA screening for men between the ages of 65 and 75 years&#44; especially if they have a history of tobacco use&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">10&#8211;14</span></a> However&#44; recent studies have questioned the actual usefulness of universal AAA screening in high-risk patients&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">15</span></a> Most AAAs diagnosed in detection programs are small &#40;maximum diameter of 3&#8211;4<span class="elsevierStyleHsp" style=""></span>cm&#41; and do not require immediate surgical repair&#44; because the risk of rupture is very low &#40;&#8804;1&#37; annually for AAAs &#60;5&#46;5<span class="elsevierStyleHsp" style=""></span>cm&#41;&#46; Over time&#44; however&#44; the size of the AAA can increase&#44; with the subsequent increase in annual rupture risk &#40;9&#46;4&#37; for AAAs between 5&#46;5 and 5&#46;9<span class="elsevierStyleHsp" style=""></span>cm&#44; 10&#46;2&#37; for AAAs between 6&#46;0 and 6&#46;9<span class="elsevierStyleHsp" style=""></span>cm and 32&#46;5&#37; for AAAs &#8805;7<span class="elsevierStyleHsp" style=""></span>cm&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">2&#44;16&#44;17</span></a> However&#44; more recent studies have reported substantially lower rupture risk values than those mentioned above &#40;3&#46;5&#37; for AAAs between 5&#46;5 and 6&#46;0<span class="elsevierStyleHsp" style=""></span>cm&#44; 4&#46;1&#37; for AAAs between 6&#46;1 and 7<span class="elsevierStyleHsp" style=""></span>cm and 6&#46;3&#37; for AAAs &#62;7<span class="elsevierStyleHsp" style=""></span>cm&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">18&#44;19</span></a> It is therefore significant that changes in patient behavior in controlling risk factors translates into reduced AAA-related mortality&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Independently of the relationship between AAA size and its rupture risk&#44; various studies have observed a greater cardiovascular risk in these patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">20&#8211;22</span></a> A possible association has been suggested between the abdominal aorta diameter and the mortality risk&#44; even when the diameter does not reach 3<span class="elsevierStyleHsp" style=""></span>cm&#44; as well as a greater risk of developing AAA in patients with subaneurysmal dilations&#46;<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">23&#8211;25</span></a> Thus&#44; the mortality rate in a prospective cohort study lasting more than 7<span class="elsevierStyleHsp" style=""></span>years was significantly higher among the men with an abdominal aorta diameter between 2&#46;5&#8211;2&#46;9<span class="elsevierStyleHsp" style=""></span>cm compared with a diameter &#60;2&#46;4<span class="elsevierStyleHsp" style=""></span>cm &#40;10&#46;3&#37; vs&#46; 7&#46;2&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">23</span></a> When the size of the aorta exceeded 3<span class="elsevierStyleHsp" style=""></span>cm&#44; the mortality increased to 17&#46;6&#37;&#46; It is therefore possible to consider the size of the abdominal aorta as a potential marker of cardiovascular risk&#44; adding this to target organ lesions&#44; which determine the presence of subclinical damage and are clearly related to a greater risk of cardiovascular complications&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Thanks to technological advances&#44; affordable high-quality portable and pocket ultrasound systems have been developed in recent years&#44; which enable point-of-care examinations and examinations during the consultation&#46; These developments have enabled the use of the systems in various specialties such as internal medicine and family medicine&#46; The ultrasound assessment of the abdominal aorta is simple and can be performed reliably by any physician with a short training period&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">26</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The study objectives were &#40;a&#41; to determine the prevalence of AAA in patients with high cardiovascular risk or who have already experienced a cardiovascular complication&#44; &#40;b&#41; to assess the relationship between aorta size and the various cardiovascular risk factors and &#40;c&#41; to assess the specific characteristics of these patients&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Patients and methods</span><p id="par0035" class="elsevierStylePara elsevierViewall">An observational&#44; cross-sectional multicenter study was conducted with the participation of 6 internal medicine units that were equipped with ultrasonography systems and experienced in its use&#46; Patient recruitment was extended to 24 months&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">and nonconsecutively included men older than 55<span class="elsevierStyleHsp" style=""></span>years and women older than 65 years with high or very high cardiovascular risk&#46; The enrollment followed the criteria of the European guidelines on the prevention of cardiovascular disease&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">27</span></a> The participants were identified and recruited opportunistically in the various healthcare settings of internal medicine &#40;hospital emergency&#44; outpatient consultation and hospitalization&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Diabetes mellitus was defined by a blood glucose level &#62;200<span class="elsevierStyleHsp" style=""></span>mg&#47;dL at any time of the day accompanied by symptoms of diabetes&#44; by fasting blood glucose levels &#8805;126<span class="elsevierStyleHsp" style=""></span>mg&#47;dL in at least 2 repeated measurements&#44; by a blood glucose level &#8805;200<span class="elsevierStyleHsp" style=""></span>mg&#47;dL 2<span class="elsevierStyleHsp" style=""></span>h after an oral glucose overload or by a glycated hemoglobin level &#8805;6&#46;5&#37;&#46; Moderate chronic kidney disease was defined by the presence of a glomerular filtration rate &#60;60<span class="elsevierStyleHsp" style=""></span>mL&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> using the Modification of Diet in Renal Disease formula&#46; The presence of microalbuminuria and proteinuria was analyzed using the albumin&#47;creatinine ratio in a single urine sample&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The recorded cardiovascular risk factors were as follows&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#8226;</span><p id="par0055" class="elsevierStylePara elsevierViewall">AHT or the use of antihypertensive therapy&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#8226;</span><p id="par0060" class="elsevierStylePara elsevierViewall">High pulse pressure &#40;difference between systolic and diastolic pressure &#62;62<span class="elsevierStyleHsp" style=""></span>mm Hg&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#8226;</span><p id="par0065" class="elsevierStylePara elsevierViewall">Tobacco use &#40;active smokers and ex-smokers&#59; quantified by packs&#47;year&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">&#8226;</span><p id="par0070" class="elsevierStylePara elsevierViewall">Dyslipidemia &#40;total cholesterol level &#62;190<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#44; low-density lipoprotein cholesterol level &#62;115<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#44; high-density lipoprotein cholesterol level &#60;40<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#44; triglyceride level &#62;150<span class="elsevierStyleHsp" style=""></span>mg&#47;dL or lipid-lowering therapy&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">&#8226;</span><p id="par0075" class="elsevierStylePara elsevierViewall">Diabetes mellitus</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">&#8226;</span><p id="par0080" class="elsevierStylePara elsevierViewall">Truncal obesity&#46;</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">&#8226;</span><p id="par0085" class="elsevierStylePara elsevierViewall">Family history of premature cardiovascular disease &#40;&#60;55 years in men and &#60;65 years in women&#41;&#46;</p></li></ul></p><p id="par0090" class="elsevierStylePara elsevierViewall">Waist circumference was measured with a nonextendable tape measure at the midpoint between the costal margin and the iliac crest&#46; Hip circumference was measured at the level of the greater trochanters&#46; The waist-hip index was calculated using the following formula&#58; waist circumference &#40;cm&#41;&#47;hip circumference &#40;cm&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">To measure the diameter of the abdominal aorta&#44; we employed a low-frequency &#40;&#60;5<span class="elsevierStyleHsp" style=""></span>MHz&#41; convex probe&#44; performing the examination with the patient in supine decubitus&#46; We performed cross-sectional slices of the aorta from the outlet of the renal arteries to the bifurcation of the iliac arteries&#44; selecting the maximum cross-sectional and anteroposterior diameters detected over the entire path of the abdominal aorta&#46; AAA was defined as the presence of an infrarenal abdominal aortic diameter &#8805;3<span class="elsevierStyleHsp" style=""></span>cm&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">We included as independent variables the demographic data&#44; patient history and signs during the examination necessary for establishing the vascular risk &#40;defined previously&#41;&#46; The dependent variable was the maximum diameter of the abdominal aorta&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">To facilitate the inclusion of the variables&#44; we designed a form on a specific web page for the study&#44; to which all researchers had individual access&#46; The online registration did not include any variable that could identify the patient&#44; thus meeting the security criteria required by the Organic Law on Data Protection&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The exclusion criteria were the following&#58; lack of desire to participate in the study and&#47;or not signing the informed consent&#44; a diagnosis of AAA prior to the start of the study&#44; inability to measure the diameter of the abdominal aorta&#44; a diagnosis of moderate-severe dementia and impairment or disorder of consciousness that prevented the voluntary signing of the informed consent&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">For the statistical analysis&#44; the quantitative variables are expressed using the arithmetic mean and deviation standard &#40;median and interquartile range for the nonparametric variables&#41;&#44; and the qualitative variables are listed by their percentage&#46; For the univariate analysis&#44; we employed Student&#39;s <span class="elsevierStyleItalic">t</span>-test &#40;and the Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test for the nonparametric variables&#41; to compare the means and used the chi-squared test &#40;<span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span>&#41; to compare the proportions&#46; In the multivariate analysis&#44; we employed binary logistic regression and included the clinically significant variables&#46; The statistical study was performed using the SPSS program version 22 &#40;SPSS&#44; Inc&#46;&#44; Chicago&#44; IL&#41;&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The study was approved by each hospital center&#39;s research committee and by the Committee of Clinical Trials of the University Hospital of Getafe&#44; Spain&#46; All included patients signed the informed consent&#46; None of the actions performed during the study delayed the patients&#8217; diagnosis or treatment&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0125" class="elsevierStylePara elsevierViewall">The study recruited a total of 688 patients&#44; 659 &#40;95&#46;7&#37;&#41; of whom were ultimately included&#46; The final group had a mean age of 71 &#40;&#177;8&#46;7&#41; years&#46; The presence of an AAA was detected in 53 patients &#40;8&#37;&#41;&#44; most of them men &#40;94&#46;3&#37;&#41;&#46; The demographic characteristics of the various groups are listed in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> shows a histogram of the frequencies of maximum abdominal aortic diameters for all patients included in the study&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0130" class="elsevierStylePara elsevierViewall">The multivariate analysis was conducted using a binary logistic regression that included 6 variables&#46; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the risk calculation for each of the variables&#46; Four variables showed an independent association with the development of AAA&#58; age&#44; sex&#44; active tobacco use and peripheral artery disease&#59; diabetes mellitus was a protective factor&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">A total of 342 patients &#40;49&#46;7&#37; of all patients&#41; were detected with subaneurysmal aortic dilation&#44; 292 of whom had diameters between 20 and 24&#46;9<span class="elsevierStyleHsp" style=""></span>mm&#59; the remaining 50 patients had diameters between 25 and 29&#46;9<span class="elsevierStyleHsp" style=""></span>mm&#46; As can be seen in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#44; the patients were predominantly men&#44; more than 65&#37; had a history of tobacco use&#44; most had AHT and dyslipidemia&#44; and almost three quarters had 3 or more simultaneous risk factors&#46; Diabetes mellitus was present in more than 60&#37; of the patients&#44; and the family history of premature vascular disease was insignificant&#46; This patient profile was similar to that of the patients with established AAA&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0140" class="elsevierStylePara elsevierViewall">Initial studies conducted in developed countries showed a prevalence of AAA of 4&#8211;7&#37; in men older than 65 years&#46;<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">28&#44;29</span></a> In more recent population studies &#40;including Spanish registries&#41;&#44; the prevalence decreased to 1&#8211;2&#37;&#44; probably due to better control of cardiovascular risk factors and reduced tobacco use in Spain&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">30</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">The prevalence of AAA in our study sample &#40;8&#37;&#41; is greater than that recorded in similar studies<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">31</span></a> and is probably due to that fact that our population had a higher mean age and a higher prevalence of tobacco use and established cardiovascular disease&#44; factors associated with a greater prevalence of AAA&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">AAA is associated with age&#44; male sex&#44; tobacco use&#44; hypertension&#44; family history of AAA and the presence of previous cardiovascular disease&#44; especially ischemic heart disease&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">32</span></a> In our study&#44; age and male sex were the demographic variables associated with a greater risk of the disease&#59; 75&#8211;80&#37; of AAAs are detected starting at the age of 67&#8211;68 years&#46; As in other published studies&#44; diabetes mellitus emerged as a protective factor for the development of AAA&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">33</span></a> It has been suggested that glycosylation of extracellular matrix molecules and the subsequent increase in their resistance to proteolysis could play a key role in this relationship&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">33</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">Among the cardiovascular risk and target organ lesion factors&#44; only tobacco consumption and peripheral artery disease showed an independent association with the presence of AAA&#44; which is probable due to the model&#39;s lack of statistical power in terms of the sample size&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Although it was not one of the study objectives and therefore not explored in depth&#44; we analyzed the characteristics of the patients with subaneurysmal aortic dilation &#40;aortic diameter between 25 and 29&#46;9<span class="elsevierStyleHsp" style=""></span>mm&#41;&#44; noting that the risk factors present in these patients were very similar to those of the patients with established AAA&#46; The natural history of these &#8220;abnormal&#8221; aortas indicated that more than 50&#37; progressed to AAA in 5 years&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">34</span></a> Although firm recommendations for the periodic screening of this population cannot currently be made&#44; a number of programs include the performance of a new ultrasonography at 5 years&#44; a strategy under review by the National Health Service Abdominal Aortic Aneurysm Screening Programme&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">35</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">A relevant aspect we should emphasize is the usefulness of abdominal ultrasonography performed by general practitioners for detecting AAA in the patient subgroup with higher vascular risk&#46; Given that it is relatively simple and safe and does not require a long training period&#44; the test can be conducted at the point-of-care during hospitalization or in the outpatient consultation&#46; As came be inferred from the study by Sis&#243;-Almirall et al&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">36</span></a> on the use of ultrasonography in primary care to detect AAAs&#44; it is possible that&#44; in the not-too-distant future&#44; the screening of this disease can be conducted in health centers by family physicians&#44; referring patients to an angiology and vascular surgery consultation in the event of a surgical indication&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">The study has its limitations&#44; such as the observer-dependent variations when performing the ultrasonography&#44; despite the fact that the procedure presents no major difficulties in its interpretation&#46; Additionally&#44; the measurement method is not standardized in the various screening programs&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">30</span></a> Moreover&#44; the diverse origins presented by the population&#44; concentrated in opportunistically identified vascular risk&#44; hinders comparisons with other well-defined healthcare settings&#46; Given that the selected population had a high or very high vascular risk&#44; the results are not extrapolatable to the rest of the population&#46; Finally&#44; studies designed to detect patients with subaneurysmal aortic dilation are needed to confirm the results in this subpopulation and the need for screening&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">In summary&#44; in the absence of a systematic policy on screening in our setting&#44; this study&#39;s findings defend the importance of an opportunistic approach for the AAA screening of patients with high and very high cardiovascular risk&#44; particularly for men older than 65 years who are smokers with a history of peripheral arterial disease&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflicts of interest</span><p id="par0180" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To determine the prevalence of abdominal aortic aneurysm &#40;AAA&#41; &#40;arterial diameter &#8805;30<span class="elsevierStyleHsp" style=""></span>mm&#41;&#44; in patients with high or very high cardiovascular risk &#40;CVR&#41; and to evaluate their clinical features&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Patients and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Observational&#44; cross-sectional and multicentric study conducted in Spanish Internal Medicine Services&#46; We enrolled men with age &#62;55 years and women &#62;65 years who had a high or very high CVR&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The study included 659 patients&#46; The prevalence of AAA was 8&#37; &#40;53 patients&#41;&#46; 76&#46;9&#37; were male with a mean age of 71<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;7 years&#46; The multivariate analysis showed an association between AAA and age &#40;OR&#58; 1&#46;06&#59; 95&#37; CI&#58; 1&#46;02&#8211;1&#46;1&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#44; male sex &#40;OR&#58; 5&#46;6&#59; 95&#37; CI&#58; 1&#46;6&#8211;18&#46;8&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#44; active smoking &#40;OR&#58; 3&#46;22&#59; 95&#37; CI&#58; 1&#46;16&#8211;8&#46;93&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;024&#41; and peripheral arterial disease &#40;OR&#58; 3&#46;51&#59; 95&#37; CI&#58; 1&#46;73&#8211;7&#46;09&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#46; Diabetes mellitus was an independent protective factor &#40;OR&#58; 0&#46;41&#59; 95&#37; CI&#58; 0&#46;22&#8211;0&#46;78&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;06&#41;&#46; Those with subaneurysmal dilatation of the abdominal aorta &#40;diameter 25&#8211;29&#46;9<span class="elsevierStyleHsp" style=""></span>mm&#41; presented similar features as patients with AAA&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The prevalence of AAA in patients with high CVR is high&#46; Ultrasound screening can be performed by general practitioners&#46; Men &#62;65 years with elevated CVR could benefit&#44; particularly in the presence of active smoking or peripheral arterial disease&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Background"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Patients and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Determinar la prevalencia de aneurisma de aorta abdominal &#40;AAA&#41;&#44; definido por un di&#225;metro arterial &#8805;<span class="elsevierStyleHsp" style=""></span>30<span class="elsevierStyleHsp" style=""></span>mm&#44; en pacientes con alto o muy alto riesgo cardiovascular &#40;RCV&#41; y evaluar sus caracter&#237;sticas cl&#237;nicas&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Pacientes y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional&#44; transversal y multic&#233;ntrico realizado en servicios de Medicina Interna del pa&#237;s a varones con edad &#62;<span class="elsevierStyleHsp" style=""></span>55<span class="elsevierStyleHsp" style=""></span>a&#241;os y mujeres &#62;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os que ten&#237;an un RCV alto o muy alto reclutados durante 24<span class="elsevierStyleHsp" style=""></span>meses&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 659 pacientes&#46; La prevalencia de AAA fue del 8&#37; &#40;53 pacientes&#41;&#46; El 76&#44;9&#37; fueron varones&#44; con edad media de 71<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;7<span class="elsevierStyleHsp" style=""></span>a&#241;os&#46; El an&#225;lisis multivariante demostr&#243; asociaci&#243;n entre AAA y la edad &#40;OR&#58; 1&#44;06&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;02-1&#44;1&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; el sexo masculino &#40;OR&#58; 5&#44;6&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;6-18&#44;8&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; el tabaquismo activo &#40;OR&#58; 3&#44;22&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;16-8&#44;93&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;024&#41; y la arteriopat&#237;a perif&#233;rica &#40;OR&#58; 3&#44;51&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;73-7&#44;09&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; siendo la diabetes mellitus un factor protector independiente &#40;OR&#58; 0&#44;41&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 0&#44;22-0&#44;78&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;06&#41;&#46; Los pacientes con dilataci&#243;n subaneurism&#225;tica de la aorta &#40;di&#225;metro de la aorta abdominal 25-29&#44;9<span class="elsevierStyleHsp" style=""></span>mm&#41; presentaban similares caracter&#237;sticas que los pacientes con AAA&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La prevalencia de AAA en pacientes de alto RCV es elevada&#46; El cribado ecogr&#225;fico puede ser realizado por m&#233;dicos generalistas&#46; Pueden beneficiarse de un cribado oportunista los varones de m&#225;s de 65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; con RCV elevado&#44; especialmente si presentan tabaquismo activo o arteriopat&#237;a perif&#233;rica&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivo"
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          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Pacientes y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Cornejo Saucedo MA&#44; Garc&#237;a-Gil D&#44; Brun Romero FM&#44; Torres do Rego A&#44; Beltr&#225;n Romero L&#44; Rodilla Sala E&#44; et al&#46; Prevalencia de aneurisma de aorta abdominal en pacientes con alto riesgo cardiovascular&#46; Rev Clin Esp&#46; 2018&#59;218&#58;461&#8211;467&#46;</p>"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Distribution of abdominal aorta diameters&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "detalles" => array:1 [
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          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; AA&#44; abdominal aorta&#59; AAA&#44; abdominal aortic aneurysm&#59; AF&#44; atrial fibrillation&#59; AHT&#44; arterial hypertension&#59; AP&#44; anteroposterior&#59; BMI&#44; body mass index&#59; DM&#44; diabetes mellitus&#59; FH&#44; family history&#59; GFR&#44; Estimated glomerular filtration rate&#59; PVD&#44; premature vascular disease&#59; RFs&#44; risk factors&#59; X&#44; cross-sectional&#46;</p>"
          "tablatextoimagen" => array:1 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Overall sample&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Patients with AAA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Patients without AAA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Patients&#44; n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">659&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">606&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age&#44; years</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">71<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">74&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Sex &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">507 &#40;76&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50 &#40;94&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">457 &#40;75&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">152 &#40;23&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;5&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">149 &#40;24&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Smoking&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">428 &#40;64&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44 &#40;83&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">384 &#40;63&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Ex-smokers</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">325 &#40;49&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29 &#40;54&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">296 &#40;48&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Active smokers</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">103 &#40;15&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;28&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88 &#40;14&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Cumulative exposure&#44; number of packs-year</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>32&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>30&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>31&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Alcohol consumption&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">182 &#40;27&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;28&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">167 &#40;27&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;913&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">AHT&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">596 &#40;90&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50 &#40;94&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">546 &#40;90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;464&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">DM&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">354 &#40;53&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18 &#40;33&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">333 &#40;54&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Dyslipidemia&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">621 &#40;94&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50 &#40;94&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">571 &#40;94&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;750&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">AF&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">91 &#40;13&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;13&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">84 &#40;13&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;545&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Cerebrovascular disease&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">122 &#40;18&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;16&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">113 &#40;18&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;765&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Ischemic heart disease&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">233 &#40;35&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24 &#40;45&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">208 &#40;34&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Peripheral artery disease&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">74 &#40;11&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;30&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37 &#40;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Estimated GFR&#44; mL&#47;min&#47;1&#46;73</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">m</span><span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>25&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;218&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Renal function stages</span></td><td class="td" title="table-entry  " align="char" valign="top">&#46;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>GFR &#62;60<span class="elsevierStyleHsp" style=""></span>mL&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">494 &#40;75&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37 &#40;69&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">457 &#40;75&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>GFR 59&#8211;30<span class="elsevierStyleHsp" style=""></span>mL&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">138 &#40;20&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;24&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">125 &#40;20&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>GFR &#60;30<span class="elsevierStyleHsp" style=""></span>mL&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27 &#40;4&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;5&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24 &#40;4&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Advanced retinopathy&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;3&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;1&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21 &#40;3&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;459&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">&#8805;3 simultaneous RFs&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">534 &#40;73&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40 &#40;75&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">447 &#40;73&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;786&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">BMI</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;348&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Waist-hip index</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;01<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;99<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;467&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Uric acid&#44; mg&#47;dL</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;620&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Albumin&#47;creatinine ratio&#44; mg&#47;g</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;3&#8211;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;5&#8211;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;3&#8211;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;281&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Presence of macroalbuminuria &#40;&#62;30</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">mg&#47;g creatinine&#41;&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">155 &#40;23&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;26&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">141 &#40;23&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Maximum X AA diameter&#44; mm</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Maximum AP AA diameter&#44; mm</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">AF PVD&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50 &#40;7&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;9&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45 &#40;74&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;599&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;02&#8211;1&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Male sex</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;66&#8211;18&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;017&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;335&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;644&#8211;2&#46;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;436&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;51&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;221&#8211;0&#46;782&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;229&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;167&#8211;8&#46;930&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;024&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ex-smokers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;459&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;597&#8211;3&#46;567&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;407&nbsp;\t\t\t\t\t\t\n
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          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; CKD&#44; chronic kidney disease&#59; PVE&#44; premature vascular disease&#59; RF&#44; risk factors&#46;</p>"
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Moderate-severe CKD &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#8805;3 simultaneous RFs&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35 &#40;70&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Creatinine clearance&#44; mL&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>23&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Characteristics of the patients with subaneurysmal aortic dilation&#46;</p>"
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      "titulo" => "References"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46;L&#46; Chaikof"
                            1 => "R&#46;L&#46; Dalman"
                            2 => "M&#46;K&#46; Eskandari"
                            3 => "B&#46;M&#46; Jackson"
                            4 => "W&#46;A&#46; Lee"
                            5 => "M&#46;A&#46; Mansour"
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                    0 => array:2 [
                      "doi" => "10.1016/j.jvs.2017.10.044"
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                        "tituloSerie" => "J Vasc Surg"
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                        "volumen" => "67"
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                        "paginaFinal" => "77"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29268916"
                            "web" => "Medline"
                          ]
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              "identificador" => "bib0190"
              "etiqueta" => "2"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Abdominal aortic aneurysm"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "K&#46; Craig Kent"
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                    0 => array:2 [
                      "doi" => "10.1056/NEJMcp1401430"
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                      "titulo" => "Abdominal aortic aneurysm"
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                            0 => "N&#46; Sakalihasan"
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                            2 => "O&#46;D&#46; Defawe"
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                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(05)66459-8"
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                      "titulo" => "The influence of screening on the incidence of ruptured abdominal aortic aneurysms"
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                          "autores" => array:4 [
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                    0 => array:1 [
                      "Revista" => array:6 [
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                      "titulo" => "Gu&#237;a para el diagn&#243;stico y tratamiento del aneurisma de aorta abdominal"
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                            2 => "L&#46;R&#46; Garc&#237;a"
                            3 => "S&#46;B&#46; Montoya"
                            4 => "A&#46;B&#46; Hernando"
                            5 => "A&#46;F&#46; Heredero"
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                    0 => array:2 [
                      "doi" => "10.1016/S0214-9168(16)30163-2"
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                        "fecha" => "2016"
                        "volumen" => "28"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27888900"
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                            3 => "S&#46; Bellmunt Montoya"
                            4 => "A&#46; Brea Hernando"
                            5 => "A&#46; Fern&#225;ndez Heredero"
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                      "titulo" => "A contemporary meta-analysis of the association of diabetes with abdominal aortic aneurysm"
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Journal Information
Vol. 218. Issue 9.
Pages 461-467 (December 2018)
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Vol. 218. Issue 9.
Pages 461-467 (December 2018)
Original article
Prevalence of abdominal aortic aneurysm in patients with high cardiovascular risk
Prevalencia de aneurisma de aorta abdominal en pacientes con alto riesgo cardiovascular
Visits
14
M.A. Cornejo Saucedoa, D. García-Gila,
Corresponding author
urgenciashupr@gmail.com

Corresponding author.
, F.M. Brun Romeroa, A. Torres do Regob, L. Beltrán Romeroc, E. Rodilla Salad, G. Acosta Guerrae, J. Villanueva Martínezf, J.M. Casas Rojof, J. Torres Machof, G. García de Casasola-Sánchezf, on behalf of the Sociedad Española de Medicina Interna y del Grupo de Trabajo de Ecografía Clínica
a Unidad de Gestión Clínica Medicina Interna y Urgencias, Hospital San Carlos, San Fernando, Cádiz, Spain
b Servicio de Medicina Interna, Hospital General Universitario Gregorio Marañón, Madrid, Spain
c Servicio de Medicina Interna, Hospital Universitario La Paz, Madrid, Spain
d Servicio de Medicina Interna, Hospital de Sagunto, Sagunto, Valencia, Spain
e Centro de Salud Las Remudas, Las Remudas, Las Palmas, Spain
f Servicio de Medicina Interna, Hospital Universitario Infanta Cristina, Parla, Madrid, Spain
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Figures (1)
Tables (3)
Table 1. Qualitative and quantitative demographic variables.
Table 2. Multivariate analysis of the risk factors of abdominal aortic aneurysms.
Table 3. Characteristics of the patients with subaneurysmal aortic dilation.
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Abstract
Background

To determine the prevalence of abdominal aortic aneurysm (AAA) (arterial diameter ≥30mm), in patients with high or very high cardiovascular risk (CVR) and to evaluate their clinical features.

Patients and methods

Observational, cross-sectional and multicentric study conducted in Spanish Internal Medicine Services. We enrolled men with age >55 years and women >65 years who had a high or very high CVR.

Results

The study included 659 patients. The prevalence of AAA was 8% (53 patients). 76.9% were male with a mean age of 71±8.7 years. The multivariate analysis showed an association between AAA and age (OR: 1.06; 95% CI: 1.02–1.1; P<0.01), male sex (OR: 5.6; 95% CI: 1.6–18.8; P=0.01), active smoking (OR: 3.22; 95% CI: 1.16–8.93; P=.024) and peripheral arterial disease (OR: 3.51; 95% CI: 1.73–7.09; P<0.01). Diabetes mellitus was an independent protective factor (OR: 0.41; 95% CI: 0.22–0.78; P=0.06). Those with subaneurysmal dilatation of the abdominal aorta (diameter 25–29.9mm) presented similar features as patients with AAA.

Conclusions

The prevalence of AAA in patients with high CVR is high. Ultrasound screening can be performed by general practitioners. Men >65 years with elevated CVR could benefit, particularly in the presence of active smoking or peripheral arterial disease.

Keywords:
Abdominal aortic aneurysm
Subaneurysmal aortic dilatation
Ultrasound
Opportunistic screening
Cardiovascular risk factors
Resumen
Objetivo

Determinar la prevalencia de aneurisma de aorta abdominal (AAA), definido por un diámetro arterial ≥30mm, en pacientes con alto o muy alto riesgo cardiovascular (RCV) y evaluar sus características clínicas.

Pacientes y métodos

Estudio observacional, transversal y multicéntrico realizado en servicios de Medicina Interna del país a varones con edad >55años y mujeres >65años que tenían un RCV alto o muy alto reclutados durante 24meses.

Resultados

Se incluyeron 659 pacientes. La prevalencia de AAA fue del 8% (53 pacientes). El 76,9% fueron varones, con edad media de 71±8,7años. El análisis multivariante demostró asociación entre AAA y la edad (OR: 1,06; IC95%: 1,02-1,1; p<0,01), el sexo masculino (OR: 5,6; IC95%: 1,6-18,8; p=0,01), el tabaquismo activo (OR: 3,22; IC95%: 1,16-8,93; p=0,024) y la arteriopatía periférica (OR: 3,51; IC95%: 1,73-7,09; p<0,01), siendo la diabetes mellitus un factor protector independiente (OR: 0,41; IC95%: 0,22-0,78; p=0,06). Los pacientes con dilatación subaneurismática de la aorta (diámetro de la aorta abdominal 25-29,9mm) presentaban similares características que los pacientes con AAA.

Conclusiones

La prevalencia de AAA en pacientes de alto RCV es elevada. El cribado ecográfico puede ser realizado por médicos generalistas. Pueden beneficiarse de un cribado oportunista los varones de más de 65años, con RCV elevado, especialmente si presentan tabaquismo activo o arteriopatía periférica.

Palabras clave:
Aneurisma de aorta abdominal
Dilatación aórtica subaneurismática
Ecografía
Cribado oportunista
Factores de riesgo vascular

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