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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
Authors: Bath, M.
Gokani, V.
Sidloff, D.
Jones, L.
Choke, E.
Sayers, R.
Bown, M. J.
First Published: 25-Dec-2015
Publisher: Elsevier
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.
DOI Link: 10.1016/j.ijsu.2015.07.060
ISSN: 1743-9191
eISSN: 1743-9159
Version: Publisher Version
Status: Peer-reviewed
Type: Journal Article
Rights: Under a Creative Commons license CC BY-NY-ND 4.0
Appears in Collections:Published Articles, Dept. of Cardiovascular Sciences

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