M F Bath1, V J Gokani1, D A Sidloff1, L R Jones1, E Choke1, R D Sayers1, M J Bown1,2. 1. Department of Cardiovascular Sciences, University of Leicester, Leicester, UK. 2. National Institute for Health Research Leicester Cardiovascular Biomedical Research Unit, University of Leicester, Leicester, UK.
Abstract
BACKGROUND: Screening for abdominal aortic aneurysm (AAA) has reduced the rate of AAA rupture. However, cardiovascular disease is still a major cause of death in men with an AAA. The aim of this study was to assess cardiovascular risk in patients with a small AAA. METHODS: Standard PRISMA guidelines were followed. Analysis was performed of studies reporting cardiovascular outcomes in patients with a small AAA (30-54 mm). Weighted metaregression was performed for cardiovascular death in patients with a small AAA, and the prevalence of cardiovascular disease was reviewed. RESULTS: Twenty-one articles were identified describing patients with an AAA, and the prevalence of, and death from, cardiovascular disease. Ten of these reported cardiovascular death rates in patients with a small AAA. Some 2323 patients with a small AAA were identified; 335 cardiovascular deaths occurred, of which 37 were due to AAA rupture. Metaregression demonstrated that the risk of cardiovascular death was 3·0 (95 per cent c.i. 1·7 to 4·3) per cent per year in patients with a small AAA (R(2) = 0·902, P < 0·001). The prevalence of ischaemic heart disease (44·9 per cent), myocardial infarction (26·8 per cent), heart failure (4·4 per cent) and stroke (14·0 per cent) was also high in these patients. CONCLUSION: The risk of cardiovascular death in patients with a small AAA is high and increases by approximately 3 per cent each year after diagnosis. Patients with a small AAA have a high prevalence of cardiovascular disease. Patients a small AAA should be considered for lifestyle modifications and secondary cardiovascular protection.
BACKGROUND: Screening for abdominal aortic aneurysm (AAA) has reduced the rate of AAArupture. However, cardiovascular disease is still a major cause of death in men with an AAA. The aim of this study was to assess cardiovascular risk in patients with a small AAA. METHODS: Standard PRISMA guidelines were followed. Analysis was performed of studies reporting cardiovascular outcomes in patients with a small AAA (30-54 mm). Weighted metaregression was performed for cardiovascular death in patients with a small AAA, and the prevalence of cardiovascular disease was reviewed. RESULTS: Twenty-one articles were identified describing patients with an AAA, and the prevalence of, and death from, cardiovascular disease. Ten of these reported cardiovascular death rates in patients with a small AAA. Some 2323 patients with a small AAA were identified; 335 cardiovascular deaths occurred, of which 37 were due to AAArupture. Metaregression demonstrated that the risk of cardiovascular death was 3·0 (95 per cent c.i. 1·7 to 4·3) per cent per year in patients with a small AAA (R(2) = 0·902, P < 0·001). The prevalence of ischaemic heart disease (44·9 per cent), myocardial infarction (26·8 per cent), heart failure (4·4 per cent) and stroke (14·0 per cent) was also high in these patients. CONCLUSION: The risk of cardiovascular death in patients with a small AAA is high and increases by approximately 3 per cent each year after diagnosis. Patients with a small AAA have a high prevalence of cardiovascular disease. Patients a small AAA should be considered for lifestyle modifications and secondary cardiovascular protection.
Authors: Marcello Casaccia Bertoluci; Rodrigo Oliveira Moreira; André Faludi; Maria Cristina Izar; Beatriz D Schaan; Cynthia Melissa Valerio; Marcelo Chiara Bertolami; Ana Paula Chacra; Marcus Vinicius Bolivar Malachias; Sérgio Vencio; José Francisco Kerr Saraiva; Roberto Betti; Luiz Turatti; Francisco Antonio Helfenstein Fonseca; Henrique Tria Bianco; Marta Sulzbach; Adriana Bertolami; João Eduardo Nunes Salles; Alexandre Hohl; Fábio Trujilho; Eduardo Gomes Lima; Marcio Hiroshi Miname; Maria Teresa Zanella; Rodrigo Lamounier; João Roberto Sá; Celso Amodeo; Antonio Carlos Pires; Raul D Santos Journal: Diabetol Metab Syndr Date: 2017-07-14 Impact factor: 3.320