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 ) .
Selective &bgr;1-Antagonism with Bisoprolol Is Associated with Fewer Postoperative Strokes than Atenolol or Metoprolol: A Single-center Cohort Study of 44,092 Consecutive Patients
Background : Perioperative metoprolol increases  postoperative stroke .  Animal studies indicate that the mechanism may be related to attenuated & bgr;2-adrenoreceptor-mediated cerebral vasodilatation . The authors therefore conducted a cohort to study whether the highly & bgr;1-specific & bgr;-blocker ( bisoprolol ) was associated with a reduced risk of postoperative stroke compared with less selective & bgr;-blockers ( metoprolol or atenolol ) . Methods : The authors conducted a single-center study on 44,092 consecutive patients with age 50 yr or more having noncardiac , nonneurologic surgery . The primary outcome was stroke within 7 days of surgery . The secondary outcome was a composite of all-cause mortality , postoperative myocardial injury , and stroke . A propensity score-matched cohort was created to assess the independent association between bisoprolol and less & bgr;1-selective agents metoprolol or atenolol . A secondary analysis using logistic regression , based on previously identified confounders , also compared selective & bgr;1-antagonism . Results : Twenty-four percent ( 10,756 ) of patients were exposed to in-hospital & bgr;-blockers . A total of 88 patients ( 0.2 % ) suffered a stroke within 7 days of surgery . The matched cohort consisted of 2,462 patients , and the pairs were well matched for all variables . Bisoprolol was associated with fewer postoperative strokes than the less selective agents ( odds ratio = 0.20 ; 95 % CI , 0.04–0.91 ) . Multivariable risk-adjustment in the & bgr;-blockers-exposed patients comparing bisoprolol with the less selective agents was associated with a similarly reduced stroke rate . Conclusions : The use of metoprolol and atenolol is associated with increased risks of postoperative stroke , compared with bisoprolol . These findings warrant confirmation in a pragmatic r and omized trial
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 ) .