Objective
The role of atherosclerosis in abdominal aortic aneurysm (AAA) pathogenesis is controversial.
The aim of this study was to compare AAA growth in patients who did and did not have
concurrent athero-occlusive disease (AOD).
Methods
Patients with an AAA measuring 35 – 49 mm in maximum diameter were recruited as part
of the TElmisartan in the management of abdominal aortic aneurysm (TEDY) trial. TEDY
participants who had infrarenal aortic volume and orthogonal diameter assessed by
computed tomography at entry and at least one other time point during the trial (12
and/or 24 months) were included. AOD was defined by prior diagnoses of coronary heart
disease, stroke, or peripheral arterial disease or an ankle brachial pressure index
< 0.90. The increase in AAA volume and diameter from entry for participants who did
and did not have AOD was assessed using linear mixed effects models; 131 of the 210
participants recruited to TEDY were included.
Results
In an unadjusted analysis, the mean (95% confidence interval) annual increases in
AAA volume and diameter for participants with AOD were 3.26 (0.82 – 5.70) cm3 and 0.70 (0.19 – 1.22) mm slower than those without AOD, p = .008 and .007 respectively. The association between AOD and significantly slower
AAA growth was maintained after adjusting for risk factors and medications, significantly
unequally distributed between participants with and without an AOD diagnosis.
Conclusion
In an exploratory analysis of a selective cohort from the TEDY trial, AOD was associated
with slower AAA growth. Validation of these findings in other cohorts is needed.
Keywords
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Article info
Publication history
Published online: March 09, 2022
Accepted:
December 27,
2021
Received:
April 5,
2021
Identification
Copyright
© 2021 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.
