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|Title:||Opportunity for cardiovascular risk factor reduction in AAA surveillance programs: a systematic review and meta-analysis of cardiovascular mortality in patients with small AAA|
Bown, M. J.
|Citation:||International Journal of Surgery, 23 (2015) S15-S134|
|Abstract:||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.|
|Rights:||Under a Creative Commons license CC BY-NY-ND 4.0 http://creativecommons.org/licenses/by-nc-nd/4.0/|
|Appears in Collections:||Published Articles, Dept. of Cardiovascular Sciences|
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