Abdominal aortic aneurysm expansion - Risk factors and time intervals for surveillance

Article

关键词: RANDOMIZED CONTROLLED-TRIAL;    EARLY ELECTIVE SURGERY;    ANKLE-ARM INDEX;    ULTRASONOGRAPHIC SURVEILLANCE;    CARDIOVASCULAR HEALTH;    RUPTURE;    GROWTH;    REPAIR;    MORTALITY;    ATHEROSCLEROSIS;   

DOI  :  10.1161/01.CIR.0000133279.07468.9F

来源: SCIE

【 摘 要 】

Background - Intervention to reduce abdominal aortic aneurysm (AAA) expansion and optimization of screening intervals would improve current surveillance programs. The aim of this study was to characterize AAA growth in a national cohort of patients with AAA both overall and by cardiovascular risk factors. Methods and Results - In this study, 1743 patients were monitored for changes in AAA diameter by ultrasonography over a mean follow-up of 1.9 years. Mean initial AAA diameter and growth rate were 43 mm (range 28 to 85 mm) and 2.6 mm/year (95% range, -1.0 to 6.1 mm/year), respectively. Baseline diameter was strongly associated with growth, suggesting that AAA growth accelerates as the aneurysm enlarges. AAA growth rate was lower in those with low ankle/brachial pressure index and diabetes but higher for current smokers (all P < 0.001). No other factor (including lipids and blood pressure) was associated with AAA growth. Intervals of 36, 24, 12, and 3 months for aneurysms of 35, 40, 45, and 50 mm, respectively, would restrict the probability of breaching the 55-mm limit at rescreening to below 1%. Conclusions - Annual, or less frequent, surveillance intervals are safe for all AAAs <= 45 mm in diameter. Smoking increases AAA growth, but atherosclerosis plays a minor role.

【 授权许可】

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