Key result
Higher preoperative anaerobic threshold predicts ~41% lower mortality after elective EVAR.
Why the study?
The study aimed to evaluate preoperative anaerobic threshold as a predictor of postoperative survival in patients undergoing elective EVAR for asymptomatic AAA.
Does preoperative anaerobic threshold predict postoperative survival in patients undergoing elective EVAR for asymptomatic AAA?
Cohort
Does preoperative anaerobic threshold predict postoperative survival in patients undergoing elective EVAR for asymptomatic AAA?
Preoperative anaerobic threshold is an independent predictor of prolonged survival following elective EVAR, which can help identify patients who will receive the most benefit from the procedure.
May inform risk stratification before elective EVAR; hypothesis-generating pending prospective validation.
BACKGROUND: The aim of this study was to examine the value preoperative AT as predictor of postoperative survival in patients who underwent elective EVAR for repair of asymptomatic AAA. METHODS: Consecutive patients who underwent elective EVAR between 2008 and 2018 were analyzed. Cardiopulmonary exercise testing was performed. Perioperative 30-day mortality was compared between patients who had AT ≥8 mL/kg/min and those with AT<8 mL/kg/min. Risk factors for postoperative survival following EVAR were examined using Cox's regression analysis. Age (HR=1.51 [CI: 1.07-1.99], P<0.05) and AT (HR=0.59 [CI: 0.45-0.76], P=0.0003) were predictors of reduced postoperative survival following elective EVAR whereas gender (HR=0.75 [CI: 0.4-1.4], P=0.37), AAA diameter (HR=0.95 [CI: 0.77-1.16], P=0.6), and AAA morphology (HR=1.23 [CI: 0.68-1.76], P=0.95) were not. CONCLUSIONS: Anaerobic threshold is an independent predictor of prolonged survival following elective EVAR and can be used to identify patients who receive most benefit from elective EVAR.
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Dawkins et al. (2020) conducted a cohort in asymptomatic abdominal aortic aneurysm. Preoperative anaerobic threshold (AT ≥8 mL/kg/min) vs. AT <8 mL/kg/min was evaluated on postoperative survival (HR 0.59, 95% CI 0.45-0.76, p=0.0003). Preoperative anaerobic threshold was an independent predictor of postoperative survival following elective endovascular repair of abdominal aortic aneurysm (HR 0.59; 95% CI 0.45-0.76; P=0.0003).
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