Current smoking and larger baseline diameter accelerated AAA growth, whereas diabetes and low ankle/brachial pressure index were associated with lower growth rates (all P<0.001).
Cohort (n=1,743)
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AAA growth accelerates with larger baseline diameter and smoking, and modeling suggests annual or less frequent surveillance is safe for AAAs ≤45 mm.
valor p: p=<0.001
BACKGROUND: Intervention to reduce abdominal aortic aneurysm (AAA) expansion and optimization of screening intervals would improve current surveillance programs. The aim of this study was to characterize AAA growth in a national cohort of patients with AAA both overall and by cardiovascular risk factors. METHODS AND RESULTS: In this study, 1743 patients were monitored for changes in AAA diameter by ultrasonography over a mean follow-up of 1.9 years. Mean initial AAA diameter and growth rate were 43 mm (range 28 to 85 mm) and 2.6 mm/year (95% range, -1.0 to 6.1 mm/year), respectively. Baseline diameter was strongly associated with growth, suggesting that AAA growth accelerates as the aneurysm enlarges. AAA growth rate was lower in those with low ankle/brachial pressure index and diabetes but higher for current smokers (all P<0.001). No other factor (including lipids and blood pressure) was associated with AAA growth. Intervals of 36, 24, 12, and 3 months for aneurysms of 35, 40, 45, and 50 mm, respectively, would restrict the probability of breaching the 55-mm limit at rescreening to below 1%. CONCLUSIONS: Annual, or less frequent, surveillance intervals are safe for all AAAs < or =45 mm in diameter. Smoking increases AAA growth, but atherosclerosis plays a minor role.
Brady et al. (Tue,) conducted a cohort in Abdominal aortic aneurysm (n=1,743). Cardiovascular risk factors (smoking, diabetes, low ankle/brachial pressure index) vs. Absence of these risk factors was evaluated on AAA growth rate (p=<0.001). Current smoking and larger baseline diameter accelerated AAA growth, whereas diabetes and low ankle/brachial pressure index were associated with lower growth rates (all P<0.001).