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 ) .
Thrombus volume is associated with cardiovascular events and aneurysm growth in patients who have abdominal aortic aneurysms.
BACKGROUND Patients with abdominal aortic aneurysms ( AAA ) are predisposed to cardiovascular events and often experience continual expansion of their aneurysm . Cardiovascular events and expansion rates are positively correlated with aneurysm size . AAA is usually associated with intraluminal thrombus , which has previously been implicated in AAA pathogenesis . This study prospect ively assessed the association of infrarenal abdominal aortic thrombus volume with cardiovascular events and AAA growth . METHODS Ninety-eight patients with AAAs underwent computed tomography angiography ( CTA ) .  The volume of infrarenal aorta thrombus was measured by a previously vali date d technique . Patients were monitored prospect ively for a median of 3 years ( interquartile range [ IQR ] , 2.0 - 3.6 years ) , and cardiovascular events ( nonfatal stroke , nonfatal myocardial infa rct ion , coronary revascularization , amputation , and cardiovascular death ) were recorded . Of the original patients , 39 underwent repeat CTA a median of 1.5 years ( IQR , 1.1 - 3.3 years ) after entry to the study . Kaplan-Meier and Cox proportional analysis were used to examine the association of aortic thrombus with cardiovascular events and average weighted AAA growth . RESULTS There were 28 cardiovascular events during follow-up . The incidence of cardiovascular events was 23.4 % and 49.2 % for patients with small ( smaller than the median ) and large ( median or larger ) volumes of aortic thrombus , respectively , at 4 years ( P = .040 ) . AAA thrombus volume of median or larger was associated with increased cardiovascular events ( relative risk [ RR ] 2.8 , 95 % confidence interval [ CI ] , 1.01 - 5.24 ) independent of other risk factors , including initial AAA diameter , but was only of borderline significance when patients were censored at the time of AAA repair ( RR , 2.35 ; 95 % CI , 0.98 - 5.63 ) . In the subset of patients with CTA follow-up , the median annual increase in AAA volume was 5.1 cm³ ( IQR , 0.8 - 10.3 cm³ ) . Annual AAA volume increase was positively correlated with initial AAA diameter ( r = 0.44 , P = .006 ) and thrombus volume ( r = 0.50 , P = .001 ) . Median or larger aortic thrombus volume was associated with rapid AAA volume increase ( ≥ 5 cm/y ) , independent of initial aortic diameter ( RR , 15.0 ; 95 % CI , 1.9 - 115.7 ; P = .009 ) . CONCLUSION In this small cohort , infrarenal aortic thrombus volume was associated with the incidence of cardiovascular events and AAA progression . These results need to be confirmed and mechanisms underlying the associations clarified in large further studies
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 ) .