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Opportunity for cardiovascular risk factor reduction in AAA surveillance programs: a systematic review and meta-analysis of cardiovascular mortality in patients with small AAA

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posted on 2017-01-16, 17:07 authored by M. Bath, V. Gokani, D. Sidloff, L. Jones, E. Choke, R. Sayers, M. J. Bown
Aim: Screening for abdominal aortic aneurysm (AAA) has dramatically reduced the rate of AAA-rupture, yet cardiovascular mortality remains a major cause of death in this patient group. A diagnosis of AAA is a powerful marker of cardiovascular risk, yet only 12.4% of patients use statins. The aim of this study was to assess the cardiovascular risk in patients with small AAA. Methods: Standard PRISMA guidelines were followed. A meta-regression analysis was performed for cardiovascular mortality in small AAA patients and a qualitative synthesis of the prevalence of concurrent cardiovascular diseases. Results: A total 2323 patients with small AAA were identified (median follow-up 5 years). A total of 335 cardiovascular deaths occurred, 37 of which from AAA-rupture, showing a cardiovascular mortality risk of 3.00% per year in small AAA patients (R2 = 0.902, p < 0.001). The prevalence of ischaemic heart disease (44.9%), myocardial infarction (26.8%), heart failure (4.4%) and cerebrovascular disease (14.0%) were high in this patient group. Discussion: There is high cardiovascular risk in patients with small AAA, yet many may not be taking advantage of optimal cardiovascular risk factor modification. The diagnosis of a small AAA should be seen as a red-flag sign, triggering lifestyle change and pharmaco-vigilance against cardiovascular risk factors.

Funding

Open Access funded by The Association of Surgeons in Training (ASiT)

History

Citation

International Journal of Surgery, 23 (2015) S15-S134

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Cardiovascular Sciences

Version

  • VoR (Version of Record)

Published in

International Journal of Surgery

Publisher

Elsevier

issn

1743-9191

eissn

1743-9159

Available date

2017-01-16

Publisher version

http://www.sciencedirect.com/science/article/pii/S1743919115004264

Language

en

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