What question did this study set out to answer?

To assess whether rates of myocardial infarction, stroke, and cardiovascular death explain why survival curves converge over time following endovascular versus open repair for large abdominal aortic aneurysms.

April 11, 2011British journal of surgery

Incidence of cardiovascular events and death after open or endovascular repair of abdominal aortic aneurysm in the randomized EVAR trial 1

View Full Paper

Ask AI

Bookmark

Why the study?

Does endovascular repair compared to open repair reduce cardiovascular events and death in patients with a large abdominal aortic aneurysm?

Key Points

To assess whether rates of myocardial infarction, stroke, and cardiovascular death explain why survival curves converge over time following endovascular versus open repair for large abdominal aortic aneurysms.
Randomized clinical trial (UK EVAR trial 1) of 1,252 patients randomly assigned between 1999 and 2004 to undergo either endovascular repair (EVAR) or open surgical repair.
Patients were monitored until September 2009 (over 5 years of follow-up) for non-fatal or fatal myocardial infarction, stroke, and cardiovascular death.
Cox proportional hazards regression models were used to compare cardiovascular event rates and deaths between randomized treatment arms across distinct time intervals.
Cardiovascular event rates were lower after EVAR compared to open repair (2.6 vs 3.2 per 100 person-years), but the difference was not statistically significant (adjusted HR 0.83, 95% CI 0.62–1.10; P = 0.199).
Overall cardiovascular mortality showed no significant difference between the EVAR and open repair cohorts (adjusted HR 1.06, 95% CI 0.83–1.36; P = 0.638).
A non-significant excess of cardiovascular deaths occurred in the EVAR group between 6 and 24 months post-procedure (adjusted HR 1.44, 95% CI 0.79–2.62; P = 0.237), contributing to overall survival curve convergence.

Structured PICO

Does endovascular repair compared to open repair reduce cardiovascular events and death in patients with a large abdominal aortic aneurysm?

Population

1252 patients with a large abdominal aortic aneurysm

Intervention

Endovascular repair (EVAR)

Comparator

Open repair

Outcome

Cardiovascular events (myocardial infarction, stroke) and cardiovascular deathhard clinical

Endovascular repair of large abdominal aortic aneurysms does not significantly reduce long-term cardiovascular events or mortality compared to open repair.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

EVAR and open repair confer equivalent long-term cardiovascular safety in large AAA; reinforces individualized choice over presumed CV benefit.

Cite This Study

Brown et al. (2011) studied this question.

synapsesocial.com/papers/6a7590f0fbccc8f4fd160d65 https://doi.org/10.1002/bjs.7485

View Full Paper

Ask AI

Bookmark

Implication

EVAR and open repair confer equivalent long-term cardiovascular safety in large AAA; reinforces individualized choice over presumed CV benefit.

Incidence of cardiovascular events and death after open or endovascular repair of abdominal aortic aneurysm in the randomized EVAR trial 1

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Incidence of cardiovascular events and death after open or endovascular repair of abdominal aortic aneurysm in the randomized EVAR trial 1

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Keep reading

Keep reading