***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Little is known about the prevalence of abdominal aortic aneurysm ( AAA ) in patients with coronary heart disease . The aims of this prospect i ve study were to evaluate the prevalence of AAA and of large abdominal aorta in patients hospitalized for acute coronary syndrome and coronary stenosis of 50 % or greater . METHODS AAA ultrasound screening was prospect ively performed in 306 patients after they gave informed consent . AAA and large abdominal aorta were defined by maximum anteroposterior diameter of 30 mm or greater and of 20 to 29 mm , respectively . Patient characteristics were prospect ively collected . Univariate and multivariate analyses were used to identify risk factors for AAA and large abdominal aorta . A p value < 0.05 was considered statistically significant . RESULTS AAAs were diagnosed in 20 patients ( 6.6 % ) . Mean diameter was 33 + /- 3.7 mm , and median diameter [ min -- max ] was 31 mm [ 30 - 45 mm ] . All except one AAA were between 30 and 40 mm . No AAAs were detected in patients younger than 50 years . Prevalence reached 7.7 % in patients older than 50 years . Using stepwise logistic regression analysis , age ( odds ratio [ OR ] 1.04 . 95 % confidence [ CI ] 1.00 - 1.09 per year of age , p = 0.06 ) and previous coronary events ( OR 2.44 , 95 % CI 0.96 - 6.25 , p = 0.06 ) showed a borderline significant association with AAA . Large infrarenal aortic diameter was observed in 32 % of patients . Age ( OR 1.03 , 95 % CI 1.02 - 1.05 per year of age , p < 0.0001 ) , male gender ( OR 16.7 , 95 % CI 6.25 - 50.0 , p < 0.0001 ) , and overweight ( OR 2.0 , 95 % CI 1.2 - 3.4 , p = 0.01 ) showed a significant independent association with large aorta . CONCLUSION AAA and large infrarenal aorta prevalence seems high in patients with acute coronary syndrome and proven coronary stenosis of 50 % or greater . Previous coronary events and older age might be associated with higher risk of AAA , and age , male gender , and obesity are significantly associated with large infrarenal aorta . If these results are confirmed in larger studies , further guidelines concerning AAA screening in this well-defined population should be considered Prospect i ve studies evaluating risk factors for abdominal aortic aneurysm are few . We studied the association of life-style factors with risk for abdominal aortic aneurysm among 29,133 male smokers 50–69 years of age , participants in the Alpha-Tocopherol , Beta-Carotene Cancer Prevention Study .  During a mean follow-up of 5.8 years , 181 were diagnosed with ruptured abdominal aortic aneurysm or nonruptured abdominal aortic aneurysm plus aneurysmectomy .  Risk for abdominal aortic aneurysm was positively associated with age [ relative risk ( RR ) = 4.56 , 95 % confidence interval ( CI ) = 2.42–8.61 for > 65 vs ≤55 years ] , smoking years ( RR = 2.25 , 95 % CI = 1.33–3.81 for > 40 vs ≤32 years ) , systolic blood pressure ( RR = 1.92 , 95 % CI = 1.13–3.25 for > 160 vs ≤130 mmHg ) , diastolic blood pressure ( RR = 1.80 , 95 % CI = 1.05–3.08 for > 100 vs ≤85 mmHg ) , and serum total cholesterol ( RR = 1.85 , 95 % CI = 1.09–3.12 for > 6.5 vs ≤5.0 mmol/liter ) . High-density lipoprotein cholesterol showed a strong inverse association with risk for aortic aneurysm ( RR = 0.16 , 95 % CI = 0.08–0.32 for > 1.5 vs ≤ 0.9 mmol/liter ) . High energy intake was associated with lower risk for aortic aneurysm ( RR = 0.59 , 95 % CI = 0.38–0.94 for the highest quartile vs the lowest ) , whereas no associations with nutrients were evident . We conclude that classical risk factors for atherosclerotic diseases seem to be important in pathogenesis of large abdominal aortic aneurysms Abstract —Few prospect i ve studies have examined associations between major cardiovascular risk factors and occurrence of abdominal aortic aneurysm ; findings from cross-sectional studies are inconsistent . This long-term population -based study assessed relationships of major risk factors in middle-age to clinical nonfatal plus fatal abdominal aortic aneurysm in older-age in the Chicago Heart Association Detection Project in Industry cohort—10 574 men and 8700 women baseline ages 40 to 64 years screened for risk factors in 1967–1973 at workplaces . With average follow-up of 30 years and clinical cases identified from Medicare records and death certificates , risk factor relationships to abdominal aortic aneurysm occurrence were assessed by Cox regression . There were among men 309 cases and among women , 109—most from Medicare records . Most findings were qualitatively similar for men and women . In multivariate analyses ( 5 models ) , hazard ratios for abdominal aortic aneurysm were significantly greater for men than women ( ≥1.97 ) , with older age ( ≥1.63/5 years ) , higher serum cholesterol ( ≥1.30/40.0 mg/dL ) , cigarettes/d ( ≥2.43/20 cigarettes ) , past smoking ( ≥1.41 ) , height ( ≥1.17/7 cm ) , evidence of adverse blood pressure ( hazard ratio 1.10/20 mm Hg higher systolic pressure , 1.12 to 1.14/12 mm Hg higher diastolic pressure , 1.87 with history of treated hypertension ) . It is concluded that major cardiovascular risk factors — serum cholesterol , smoking , and blood pressure — in middle age relate significantly to risk of abdominal aortic aneurysm in persons surviving into older age BACKGROUND To evaluate factors associated with incidence and 3-year all-cause mortality in patients with aortic aneurysm ( AA ) . The design is sex and age-stratified ( 60 - 79 and 80 - 90 years ) prospect i ve cohort . By using the population register , we constituted a cohort of all men and women born between 1900 and 1930 and living in Scania by 1991 , and followed them for 13 years . Identification of AA was based on hospital discharge diagnosis obtained from the Swedish Patient Register or from the information on death certificates from the Cause of Death Register . METHODS We applied stepwise Cox regression and investigated both AA incidence ( 1991 - 2003 ) as well as 3-year survival after the first hospitalization for AA . RESULTS We found an inverse relation between AA incidence and previous hospitalization by diabetes mellitus in women ( hazard ratio [ HR ] : 0.41 ; 95 % confidence interval [ CI ] : 0.19 - 0.88 ) and in men ( HR : 0.38 ; 95 % CI : 0.24 - 0.61 ) aged 60 - 79 years . Three-year all-cause mortality after diagnosis of AA was 58.6 % in women , 50.2 % in men , 72.9 % in octogenarians , and 43.7 % for nonoctogenarians . Low income , chronic respiratory diseases , cerebrovascular diseases , dementia , systemic connective tissue disorders , renal failure , and malignant neoplasms were independent factors for mortality in 60 - 79-year-old men with AA . CONCLUSIONS Inferior socioeconomic position is associated with increased 3-year all-cause mortality in 60 - 79-year-old men with AA OBJECTIVE To study the growth rate and factors influencing progression of small infrarenal abdominal aortic aneurysms ( AAA ) .  DESIGN Observational , longitudinal , prospect i ve study . PATIENTS AND METHODS We followed patients with AAA < 5 cm in diameter in two groups . Group I ( AAA 3 - 3.9 cm , n = 246 ) underwent annual ultrasound scans . Group II ( AAA 4 - 4.9 cm , n = 106 ) underwent 6-monthly CT scans . RESULTS We included 352 patients ( 333 men and 19 women ) followed for a mean of 55.2+/-37.4 months ( 6.3 - 199.8 ) . The mean growth rate was significantly greater in group II ( 4.72+/-5.93 vs. 2.07+/-3.23 mm/year ; p<0.0001 ) . Group II had a greater percentage of patients with rapid aneurysm expansion ( > 4 mm/year ) ( 36.8 vs. 13.8 % ; p<0.0001 ) . The classical cardiovascular risk factors did not influence the AAA growth rate in group I. Chronic limb ischemia was associated with slower expansion ( < or = 4 mm/year ) ( OR 0.47 ; CI 95 % 0.22 - 0.99 ; p = 0.045 ) . Diabetic patients in group II had a significantly smaller mean AAA growth rate than non-diabetics ( 1.69+/-3.51 vs. 5.22+/-6.11 mm/year ; p = 0.032 ) . CONCLUSIONS The expansion rate of small AAA increases with the AAA size . AAA with a diameter of 3 - 3.9 cm exp and slowly , and they are very unlikely to require surgical repair in 5 years . Many 4 - 4.9 cm AAA can be expected to reach a surgical size in the first 2 years of follow-up . Chronic limb ischemia and diabetes are associated with reduced aneurysm growth rates A number of studies have compared results after aortic procedures in diabetics vs nondiabetics but few have focused specifically on abdominal aortic aneurysm surgery . An analysis of prospect i ve data was carried out in the Vascular Surgery Registry ( Beth Israel Deaconess Medical Center , Boston , MA ) and identified 421 patients ( 422 grafts ) who underwent elective open repair of an abdominal aortic aneurysm between 1990 and 1999 . The influence of diabetes mellitus on outcome was assessed by dividing the patients into two groups : 52 diabetic and 370 nondiabetic patients .  Postoperative mortality was 1.7 % overall ( n = 7 ) and proportionally higher in the diabetic population , although this did not reach statistical significance ( 3.8 % vs 1.4 % , p = 0 . 19 ) . However , cumulative survival at 1 year and 3 years was essentially identical for diabetic vs nondiabetic patients ( 91.0 % vs 92.6 % and 70.0 % vs 73.5 % , respectively ) and did not diverge until 5 years after surgery ( 25.0 % vs 50.9 % respectively [ p>0.05 ] ) . Overall , major complications occurred in 1 1 diabetics ( 21.2 % ) vs 58 nondiabetics ( 15.7 % , p = 0.32 ) . Specific complications that were increased in the diabetic population included pancreatitis ( 5.8 % vs 1.1 % , p = 0.01 ) and pneumonia ( 1 1.5 % vs 3.2 % , p = 0.006 ) . Notably , overall cardiac morbidity was not higher in patients with diabetes mellitus ( 1.9 % vs 4.3 % , p = 0.41 ) . Our data suggest that after elective open abdominal aortic aneurysm repair , patients with diabetes mellitus may have a higher rate of certain complications when compared to patients without diabetes mellitus . These differences however , do not preclude the expectation of excellent results of open abdominal aortic aneurysm repair in patients with diabetes mellitus Despite the known protective association between moderate alcohol consumption and ischemic heart disease , little is known about the effects of alcohol consumption on abdominal aortic aneurysms ( AAA ) . The authors analyzed prospect i ve , biennially up date d data for a cohort of 39,352 US men from 1986 to 2002 . The association of incident AAA diagnosis with alcohol consumption in grams per day was assessed at baseline and by using alcohol consumption data up date d every 4 years , controlling for previously reported cardiovascular risk factors . During 576,374 person-years of follow-up , 376 newly diagnosed cases of AAA were demonstrated . After adjustment for other risk factors for AAA , including smoking , hy 
    Output:
    
In the long-term , diabetics showed lower survival rates at 2 - 5 years , while there was general evidence of lower growth rates of small AAA in patients with diabetes compared to non-diabetics .
At the same time , operative and long-term survival is lower in diabetic patients , suggesting increased cardiovascular burden .