Key result
Between 1999 and 2018, all-cause mortality in patients with abdominal aortic aneurysm decreased from 24.3 to 12.4 deaths per 100 person-years, alongside increased use of cardioprotective therapy.
Why the study?
Abdominal aortic aneurysmal disease carries increased cardiovascular morbidity and death that may be reduced by cardioprotective medical therapy, prompting evaluation of temporal trends in comorbidity and medication use.
Cohort (n=33,296)
In patients with abdominal aortic aneurysms, cardiovascular comorbidity and mortality have decreased over the past 20 years, while the use of cardioprotective medical therapy has increased but plateaued since 2013, indicating room for further improvement.
AIMS: Abdominal aortic aneurysmal disease is associated with increased risk of cardiovascular morbidity and death, which potentially can be reduced with cardioprotective medical therapy. The aim of this study was to observe temporal trends in prevalence and incidence of cardiovascular comorbidity as well as use of medical cardioprotective treatment in patients diagnosed with abdominal aortic aneurysmal disease. METHODS AND RESULTS: This was a population-based cohort study based on data from national health registries, including all patients diagnosed with abdominal aortic aneurysms between 1998 and 2018. Data were stratified into four time periods (1999-2003, 2004-2008, 2009-2013, and 2014-2018) to illustrate trends over time. Outcome measures were (i) cardiovascular comorbidity and medical cardioprotective therapy at time of diagnosis, (ii) new admissions for atherosclerotic cardiovascular disease, and (iii) all-cause mortality after 2-year follow-up. The study cohort included 33 296 individuals. Mean age was 74 years. Prevalence of atherosclerotic cardiovascular comorbidity at diagnosis decreased from 41.5 to 32.6%. Use of statins increased from 17.9 to 66.9%, antiplatelets from 45.6 to 63.3%, and combined therapy with both antiplatelets and statins from 11.3 to 44.8%, and from 12.1 to 50.7% when anticoagulant therapy was included. Developments in medication use plateaued after 2013. Prevalence and incidence of atherosclerotic cardiovascular disease decreased through all four time periods. The same applied to all-cause mortality, which decreased from 24.3 to 12.4 deaths (per 100 person-years). CONCLUSION: In patients diagnosed with abdominal aortic aneurysm, cardiovascular comorbidity at diagnosis, risk of future cardiovascular events, and all-cause mortality is decreasing. Nevertheless, cardiovascular burden and mortality rates remain substantial, and medical cardioprotective therapy can be further improved.
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Nicolajsen et al. (2022) conducted a cohort in Abdominal aortic aneurysmal disease (n=33,296). Time period of diagnosis (2014-2018) vs. Earlier time period (1999-2003) was evaluated on All-cause mortality at two-year follow-up (deaths per 100 person-years). Between 1999 and 2018, all-cause mortality in patients with abdominal aortic aneurysm decreased from 24.3 to 12.4 deaths per 100 person-years, alongside increased use of cardioprotective therapy.
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