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Risk Factors May Predict Course of Small AAAs


 

BALTIMORE — Patients who use lipid-lowering drugs showed a lower rate of growth of abdominal aortic aneurysms, compared with patients who did not use these drugs, said Dr. Felix J.V. Schlösser in a presentation at the Vascular Annual Meeting.

Patients with manifest arterial vascular disease or cardiovascular risk factors who were enrolled in the Second Manifestation of Arterial Disease (SMART) trial from between September 1996 and January 2005 all had measurements made of their abdominal aortic diameter, said Dr. Schlösser in an interview.

The subgroup of patients with AAA diameters measuring 30–55 mm were selected for this study, which was presented by Dr. Schlösser and his colleagues from the University Medical Center Utrecht (the Netherlands) in a session sponsored by the Peripheral Vascular Surgery Society.

The 230 patients averaged 66 years of age, and 90% were male. Mortality at 2 and 5 years was nearly 8% and slightly over 25%, respectively. A total of four AAA ruptures occurred, all of which were fatal and occurred in patients with AAA diameters larger than 50 mm. In 109 patients, AAA measurements were performed for longer than 6 months, with a median follow-up time of 3.3 years. The mean diameter of the AAA in these patients was 40.7 mm, with a median expansion rate of 2.8 mm/year. The only factor independently and significantly associated with AAA growth was the use of lipid-lowering drugs. Patients on lipid-lowering drugs had a plus or minus 30% millimeter per year-lower AAA growth rate, compared with patients who did not use these drugs. Confirmation by a randomized controlled trial is required, however. Lipid-lowering drugs could possibly become part of standard treatment regimens for AAA patients.

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