Due to the limited number of included trials , there is insufficient evidence to draw any conclusions about the effectiveness of cardiovascular prophylaxis in reducing mortality and cardiovascular events in people with AAA .
BACKGROUND Pharmacological prophylaxis has been proven to reduce the risk of cardiovascular events in individuals with atherosclerotic occlusive arterial disease .
However , the role of prophylaxis in individuals with abdominal aortic aneurysm ( AAA ) remains unclear .
Several studies have shown that despite successful repair , those people with AAA have a poorer rate of survival than healthy controls .
People with AAA have an increased prevalence of coronary heart disease and risk of cardiovascular events .
Despite this association , little is known about the effectiveness of pharmacological prophylaxis in reducing cardiovascular risk in people with AAA .
This is an up date of a Cochrane review first published in 2014 .
OBJECTIVES To determine the long-term effectiveness of antiplatelet , antihypertensive or lipid-lowering medication in reducing mortality and cardiovascular events in people with abdominal aortic aneurysm ( AAA ) .
Cardiovascular predictors for long-term mortality after EVAR for AAA
The aim of this study was to assess cardiovascular predictors for all-cause long-term mortality in patients undergoing st and ard endovascular aneurysm repair ( EVAR ) for infrarenal abdominal aortic aneurysm ( AAA ) . Consecutive patients treated with EVAR ( Zenith ® stent grafts ; Cook ) between May 1998 and February 2006 were prospect ively enrolled in a computerized data base , together with retrospectively collected data on medication , and electrocardiographic and echocardiographic variables . Mortality was assessed on 1 December 2010 . The median follow-up time was 68 months and the median age was 74 years ( range 53–89 ) for the 304 patients . Mortality at the end of follow-up was 54.3 % ( 165/304 ) . The proportion of deaths caused by vascular diseases was 61 % ( 101/165 ) . In the univariate analysis , low preoperative ejection fraction ( EF ) ( p = 0.004 ) , absence of statin medication ( p = 0.007 ) , and medication with diuretics ( p = 0.028 ) or digitalis ( p = 0.016 ) were associated with an increased long-term mortality rate . Myocardial ischemia on electrocardiogram ( ECG ) ( hazard ratio ( HR ) 1.6 [ 95 % CI 1.1–2.4 ] ) and anemia ( HR 1.5 [ 95 % CI 1.0–2.1 ] ) were found to be independent predictors for long-term mortality after Cox regression analysis . There was a trend that chronic kidney disease , stage ≥ 3 ( HR 1.5 [ 95 % CI 1.0–2.2 ] ) , and age 80 years and above ( HR 1.5 [ 95 % CI 1.0–2.4 ] ) were independently associated with long-term mortality . In conclusion , ischemia on ECG and anemia were independently related to an increased long-term mortality rate after EVAR , and these predictive factors seem to be most important for critical assessment in the preoperative medical work-up
Due to the limited number of included trials , there is insufficient evidence to draw any conclusions about the effectiveness of cardiovascular prophylaxis in reducing mortality and cardiovascular events in people with AAA .
BACKGROUND Pharmacological prophylaxis has been proven to reduce the risk of cardiovascular events in individuals with atherosclerotic occlusive arterial disease .
However , the role of prophylaxis in individuals with abdominal aortic aneurysm ( AAA ) remains unclear .
Several studies have shown that despite successful repair , those people with AAA have a poorer rate of survival than healthy controls .
People with AAA have an increased prevalence of coronary heart disease and risk of cardiovascular events .
Despite this association , little is known about the effectiveness of pharmacological prophylaxis in reducing cardiovascular risk in people with AAA .
This is an up date of a Cochrane review first published in 2014 .
OBJECTIVES To determine the long-term effectiveness of antiplatelet , antihypertensive or lipid-lowering medication in reducing mortality and cardiovascular events in people with abdominal aortic aneurysm ( AAA ) .