Abdominal aortic aneurysm

Metadata

Name	Abdominal aortic aneurysm (AAA)
Category	Cardiovascular
Sex
Adult	Yes
UUID	be024cd4-f3a3-4ea7-a039-b15235bd1b19
Definition	An abdominal aortic aneurysm (AAA) is a bulge or swelling in the aorta, the main blood vessel that runs from the heart down through the chest and stomach.

Ontologies

Disease Ontology (DOID)	DOID_50602
GWAS Catalogue	EFO_0004214
MeSH	D017544
SNOMED-CT	233985008
FinnGen	I9_ABAORTANEUR

Key Summary Statistics

Cases from any source

Total	3464
Female (%)	653 (19%)
Male (%)	2811 (81%)

Year first recorded

Cases linked in all UK Biobank sources

Cross-source concordance

Vertical bars correspond to number of cases per source/intersection; horizontal bars to left correspond to total number of cases per source.

Incidence & prevalence

Baseline prevalence stratified by sex

Female	5.19 (3.65,6.72)
Male	22.96 (19.45,26.47)

Incidence stratified by sex

Female	0.88 (0.64,1.12)
Male	5.89 (5.2,6.58)

Incidence stratified by age

Ages 40-44	0.3 (-0.04,0.64)
Ages 45-49	0.52 (0.13,0.9)
Ages 50-54	0.63 (0.24,1.03)
Ages 55-59	2.13 (1.48,2.78)
Ages 60-64	4.65 (3.83,5.48)
Ages 65-69	7.41 (6.22,8.61)

Period prevalence

Methods

Comparison with general population

Sex-standardised prevalence from CALIBER study (Kuan et al. 2019)

Population	Ages 40-49	Ages 50-59	Ages 60-69
UK Biobank	3 (2,6)	11 (8,13)	45 (40,49)
CALIBER	4 (3,4)	13 (12,14)	91 (88,94)

Stratified by age and Townsend deprivation status

Deprivation status	Ages 40-49	Ages 50-59	Ages 60-69
Least deprived	3(0,11)	4(1,9)	38(30,48)
Low	3(0,10)	9(4,16)	50(40,61)
Medium	6(2,15)	13(8,22)	40(31,50)
High	4(1,11)	9(5,17)	44(35,56)
Most deprived	1(0,5)	17(10,26)	52(41,65)

Stratified by age and country

Country	Ages 40-49	Ages 50-59	Ages 60-69
England	3(1,6)	11(8,14)	46(41,51)
Scotland	0(NaN,NaN)	12(6,22)	37(26,51)
Wales	11(2,32)	9(2,22)	44(30,64)

Risk factors analysis

‘Healthy’ BMI, smoking status ‘never’, or no hypertension (absence of hypertension records) were considered as reference values.

Hazard Ratio (HR) values with P < 0.0002 were considered to show significant association with disease onset after correction for multiple-testing using the Bonferroni method

N=154060, Events=218

Factor	Level	Hazard Ratio	P value
BMI	overweight	0.89 (0.65, 1.23)	0.488
BMI	obese	1.16 (0.82, 1.63)	0.404
BMI	underweight	0 (0, Inf)	0.989
smoking	previous	1.75 (1.31, 2.35)	0.000182
smoking	current	2.37 (1.58, 3.55)	3.07e-05
hypertension	yes	1 (0.74, 1.36)	0.997

Definition

UK Biobank field id	Description	Code	Value
20004	Operation code	1104	aortic aneurysm/repair or stent
41202	Diagnoses - main ICD10	I71.4	Abdominal aortic aneurysm, without mention of rupture
41202	Diagnoses - main ICD10	I71.6	Thoracoabdominal aortic aneurysm, without mention of rupture
41202	Diagnoses - main ICD10	I71.9	Aortic aneurysm of unspecified site, without mention of rupture
41204	Diagnoses - secondary ICD10	I71.4	Abdominal aortic aneurysm, without mention of rupture
41204	Diagnoses - secondary ICD10	I71.6	Thoracoabdominal aortic aneurysm, without mention of rupture
41204	Diagnoses - secondary ICD10	I71.9	Aortic aneurysm of unspecified site, without mention of rupture
41200	Operative procedures - main OPCS4	L18	Emergency replacement of aneurysmal segment of aorta
41200	Operative procedures - main OPCS4	L19	Other replacement of aneurysmal segment of aorta
41200	Operative procedures - main OPCS4	L20	Other emergency bypass of segment of aorta
41200	Operative procedures - main OPCS4	L27	Transluminal insertion of stent graft for aneurysmal segment of aorta
41200	Operative procedures - main OPCS4	L28	Transluminal operations on aneurysmal segment of aorta
41200	Operative procedures - main OPCS4	L254	Operations on aneurysm of aorta NEC
41200	Operative procedures - main OPCS4	L209	Unspecified other emergency bypass of segment of aorta
41210	Operative procedures - secondary OPCS4	L18	Emergency replacement of aneurysmal segment of aorta
41210	Operative procedures - secondary OPCS4	L19	Other replacement of aneurysmal segment of aorta
41210	Operative procedures - secondary OPCS4	L20	Other emergency bypass of segment of aorta
41210	Operative procedures - secondary OPCS4	L27	Transluminal insertion of stent graft for aneurysmal segment of aorta
41210	Operative procedures - secondary OPCS4	L28	Transluminal operations on aneurysmal segment of aorta
41210	Operative procedures - secondary OPCS4	L254	Operations on aneurysm of aorta NEC
41210	Operative procedures - secondary OPCS4	L209	Unspecified other emergency bypass of segment of aorta
40001	Underlying (primary) cause of death: ICD10	I71.4	Abdominal aortic aneurysm, without mention of rupture
40001	Underlying (primary) cause of death: ICD10	I71.6	Thoracoabdominal aortic aneurysm, without mention of rupture
40001	Underlying (primary) cause of death: ICD10	I71.9	Aortic aneurysm of unspecified site, without mention of rupture
40002	Contributory (secondary) causes of death: ICD10	I71.4	Abdominal aortic aneurysm, without mention of rupture
40002	Contributory (secondary) causes of death: ICD10	I71.6	Thoracoabdominal aortic aneurysm, without mention of rupture
40002	Contributory (secondary) causes of death: ICD10	I71.9	Aortic aneurysm of unspecified site, without mention of rupture
42040	GP clinical event records	7A11000	Emerg repl aneurysm bifurc aorta by anast aorta to fem art
42040	GP clinical event records	7A11200	Emerg repl aneurysm bifurc aorta by anast aorta to iliac a
42040	GP clinical event records	7A11211	Y graft of abdominal Aortic aneurysm (emergency)
42040	GP clinical event records	7A13.00	Emergency replacement of aneurysmal segment of aorta
42040	GP clinical event records	7A13.11	Emergency repair of aortic aneurysm
42040	GP clinical event records	7A13300	Emerg replace aneurysm infrarenal aorta by anast aorta/aorta
42040	GP clinical event records	7A13400	Emerg replace aneurysm abdom aorta by anast aorta/aorta NEC
42040	GP clinical event records	7A13411	Tube graft abdominal Aortic aneurysm (emergency)
42040	GP clinical event records	7A13y00	Emergency replacement of aneurysmal segment of aorta OS
42040	GP clinical event records	7A13z00	Emergency replacement of aneurysmal segment of aorta NOS
42040	GP clinical event records	G714.00	Abdominal aortic aneurysm without mention of rupture
42040	GP clinical event records	G714.11	AAA - Abdominal aortic aneurysm without mention of rupture
42040	GP clinical event records	G716.00	Aortic aneurysm without mention of rupture NOS
42040	GP clinical event records	G716000	Thoracoabdominal aortic aneurysm, without mention of rupture
42040	GP clinical event records	14AE.00	H/O: aortic aneurysm
42040	GP clinical event records	XE0F2	Emergency replacement of aneurysmal segment of abdominal aorta by anastomosis of aorta to aorta NEC
42040	GP clinical event records	XE0Ey	Emergency replacement of aneurysmal bifurcation of aorta by anastomosis of aorta to iliac artery