Multicentre study of abdominal aortic aneurysm measurement and enlargement
Background No effective treatment is currently available to prevent progression of small and medium‐sized abdominal aortic aneurysms (AAAs). Identification of drugs with sufficient promise to justify large expensive randomized trials remains challenging. One potentially useful strategy is to look fo...
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| Veröffentlicht in: | British journal of surgery 2015-11, Vol.102 (12), p.1480-1487 |
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| creator | Lederle, F. A. Noorbaloochi, S. Nugent, S. Taylor, B. C. Grill, J. P. Kohler, T. R. Cole, L. |
| description | Background
No effective treatment is currently available to prevent progression of small and medium‐sized abdominal aortic aneurysms (AAAs). Identification of drugs with sufficient promise to justify large expensive randomized trials remains challenging. One potentially useful strategy is to look for associations between commonly used drugs and AAA enlargement in appropriately adjusted observational studies.
Methods
Potential AAA measurements were identified from abdominal imaging reports in the electronic data files of three medical centres from 1995 to 2010. AAA measurements were extracted manually and patients with an aneurysm of 3 cm or larger, who had at least two measurements over an interval of at least 6 months, were identified. Other data were obtained from the electronic data files (demographics, co‐morbidities, smoking status, drug use) to conduct a propensity analysis of the associations of drugs and other factors with AAA enlargement.
Results
From 52 962 abdominal imaging studies, 5362 patients with an AAA of 3 cm or more were identified, of whom 2428 had at least two measurements over at least 6 months. Mean AAA follow‐up was 3·4 years and the mean AAA enlargement rate was 2·0 mm per year. Propensity analysis demonstrated no significant association of AAA enlargement with statins, beta‐blockers, angiotensin‐converting enzyme inhibitors or angiotensin II receptor blockers. Diabetes was associated with a reduction in AAA enlargement of 1·2 mm per year (P = 0·008), and chronic obstructive pulmonary disease was associated with increased enlargement (0·5 mm per year; P = 0·050). Moderate AAA measurement variation and substantial terminal digit preference were also observed, but the digit preference became less pronounced after 2000.
Conclusion
This study confirms the negative association of diabetes with AAA progression. There was no evidence that commonly used cardiovascular drugs affect AAA enlargement.
Nothing to reduce growth |
| doi_str_mv | 10.1002/bjs.9895 |
| format | Article |
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No effective treatment is currently available to prevent progression of small and medium‐sized abdominal aortic aneurysms (AAAs). Identification of drugs with sufficient promise to justify large expensive randomized trials remains challenging. One potentially useful strategy is to look for associations between commonly used drugs and AAA enlargement in appropriately adjusted observational studies.
Methods
Potential AAA measurements were identified from abdominal imaging reports in the electronic data files of three medical centres from 1995 to 2010. AAA measurements were extracted manually and patients with an aneurysm of 3 cm or larger, who had at least two measurements over an interval of at least 6 months, were identified. Other data were obtained from the electronic data files (demographics, co‐morbidities, smoking status, drug use) to conduct a propensity analysis of the associations of drugs and other factors with AAA enlargement.
Results
From 52 962 abdominal imaging studies, 5362 patients with an AAA of 3 cm or more were identified, of whom 2428 had at least two measurements over at least 6 months. Mean AAA follow‐up was 3·4 years and the mean AAA enlargement rate was 2·0 mm per year. Propensity analysis demonstrated no significant association of AAA enlargement with statins, beta‐blockers, angiotensin‐converting enzyme inhibitors or angiotensin II receptor blockers. Diabetes was associated with a reduction in AAA enlargement of 1·2 mm per year (P = 0·008), and chronic obstructive pulmonary disease was associated with increased enlargement (0·5 mm per year; P = 0·050). Moderate AAA measurement variation and substantial terminal digit preference were also observed, but the digit preference became less pronounced after 2000.
Conclusion
This study confirms the negative association of diabetes with AAA progression. There was no evidence that commonly used cardiovascular drugs affect AAA enlargement.
Nothing to reduce growth</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1002/bjs.9895</identifier><identifier>PMID: 26331269</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Adrenergic beta-Antagonists - therapeutic use ; Aged ; Aneurysm, Ruptured - diagnosis ; Aneurysm, Ruptured - drug therapy ; Aneurysm, Ruptured - surgery ; Angiotensin-Converting Enzyme Inhibitors - therapeutic use ; Aortic Aneurysm, Abdominal - diagnosis ; Aortic Aneurysm, Abdominal - drug therapy ; Aortic Aneurysm, Abdominal - surgery ; Disease Progression ; Female ; Follow-Up Studies ; Humans ; Male ; Prognosis ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Time Factors ; Tomography, X-Ray Computed - methods ; Ultrasonography, Doppler - methods ; Vascular Surgical Procedures - methods</subject><ispartof>British journal of surgery, 2015-11, Vol.102 (12), p.1480-1487</ispartof><rights>Published 2015. This article is a U.S. Government work and is in the public domain in the USA.</rights><rights>Copyright © 2015 BJS Society Ltd. Published by John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5245-b2da7b1606a8a1e3ac91391bfa8b7388415b2472f789035cc706ed9bf1b331cb3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fbjs.9895$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fbjs.9895$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26331269$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lederle, F. A.</creatorcontrib><creatorcontrib>Noorbaloochi, S.</creatorcontrib><creatorcontrib>Nugent, S.</creatorcontrib><creatorcontrib>Taylor, B. C.</creatorcontrib><creatorcontrib>Grill, J. P.</creatorcontrib><creatorcontrib>Kohler, T. R.</creatorcontrib><creatorcontrib>Cole, L.</creatorcontrib><title>Multicentre study of abdominal aortic aneurysm measurement and enlargement</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Background
No effective treatment is currently available to prevent progression of small and medium‐sized abdominal aortic aneurysms (AAAs). Identification of drugs with sufficient promise to justify large expensive randomized trials remains challenging. One potentially useful strategy is to look for associations between commonly used drugs and AAA enlargement in appropriately adjusted observational studies.
Methods
Potential AAA measurements were identified from abdominal imaging reports in the electronic data files of three medical centres from 1995 to 2010. AAA measurements were extracted manually and patients with an aneurysm of 3 cm or larger, who had at least two measurements over an interval of at least 6 months, were identified. Other data were obtained from the electronic data files (demographics, co‐morbidities, smoking status, drug use) to conduct a propensity analysis of the associations of drugs and other factors with AAA enlargement.
Results
From 52 962 abdominal imaging studies, 5362 patients with an AAA of 3 cm or more were identified, of whom 2428 had at least two measurements over at least 6 months. Mean AAA follow‐up was 3·4 years and the mean AAA enlargement rate was 2·0 mm per year. Propensity analysis demonstrated no significant association of AAA enlargement with statins, beta‐blockers, angiotensin‐converting enzyme inhibitors or angiotensin II receptor blockers. Diabetes was associated with a reduction in AAA enlargement of 1·2 mm per year (P = 0·008), and chronic obstructive pulmonary disease was associated with increased enlargement (0·5 mm per year; P = 0·050). Moderate AAA measurement variation and substantial terminal digit preference were also observed, but the digit preference became less pronounced after 2000.
Conclusion
This study confirms the negative association of diabetes with AAA progression. There was no evidence that commonly used cardiovascular drugs affect AAA enlargement.
Nothing to reduce growth</description><subject>Adrenergic beta-Antagonists - therapeutic use</subject><subject>Aged</subject><subject>Aneurysm, Ruptured - diagnosis</subject><subject>Aneurysm, Ruptured - drug therapy</subject><subject>Aneurysm, Ruptured - surgery</subject><subject>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</subject><subject>Aortic Aneurysm, Abdominal - diagnosis</subject><subject>Aortic Aneurysm, Abdominal - drug therapy</subject><subject>Aortic Aneurysm, Abdominal - surgery</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Time Factors</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Ultrasonography, Doppler - methods</subject><subject>Vascular Surgical Procedures - methods</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0F1PwyAUBmBiNG5OE3-BaeKNN50cGIVe6qLTbU6TzXhJoKWms10ntNH9e9mHM_HqBM4DHF6EzgF3AWNyreeuG4uYHaA20IiFBCJxiNoYYx4CJbSFTpybYwwUM3KMWiSiFEgUt9HwqSnqPDGL2prA1U26CqosUDqtynyhikBV1rcDtTCNXbkyKI1yjTWlP-A308AsCmXfN-tTdJSpwpmzXe2g1_u7Wf8hHD8PHvs34zBhpMdCTVLFNUQ4UkKBoSqJgcagMyU0p0L0gGnS4yTjIsaUJQnHkUljnYH2QyeadtDV9t6lrT4b42pZ5i4xReGHrBongRMCQuC45-nlPzqvGuv_tVH-WUaAeXWxU40uTSqXNi-VXcnflDwIt-ArL8xq3wcs1-lLn75cpy9vh9N1_fO5q8333iv7ISNOOZNvk4GcjoZs9jKcyBH9AWAzhS0</recordid><startdate>201511</startdate><enddate>201511</enddate><creator>Lederle, F. A.</creator><creator>Noorbaloochi, S.</creator><creator>Nugent, S.</creator><creator>Taylor, B. C.</creator><creator>Grill, J. P.</creator><creator>Kohler, T. R.</creator><creator>Cole, L.</creator><general>John Wiley & Sons, Ltd</general><general>Oxford University Press</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201511</creationdate><title>Multicentre study of abdominal aortic aneurysm measurement and enlargement</title><author>Lederle, F. A. ; Noorbaloochi, S. ; Nugent, S. ; Taylor, B. C. ; Grill, J. P. ; Kohler, T. R. ; Cole, L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5245-b2da7b1606a8a1e3ac91391bfa8b7388415b2472f789035cc706ed9bf1b331cb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adrenergic beta-Antagonists - therapeutic use</topic><topic>Aged</topic><topic>Aneurysm, Ruptured - diagnosis</topic><topic>Aneurysm, Ruptured - drug therapy</topic><topic>Aneurysm, Ruptured - surgery</topic><topic>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</topic><topic>Aortic Aneurysm, Abdominal - diagnosis</topic><topic>Aortic Aneurysm, Abdominal - drug therapy</topic><topic>Aortic Aneurysm, Abdominal - surgery</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Time Factors</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Ultrasonography, Doppler - methods</topic><topic>Vascular Surgical Procedures - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lederle, F. A.</creatorcontrib><creatorcontrib>Noorbaloochi, S.</creatorcontrib><creatorcontrib>Nugent, S.</creatorcontrib><creatorcontrib>Taylor, B. C.</creatorcontrib><creatorcontrib>Grill, J. P.</creatorcontrib><creatorcontrib>Kohler, T. R.</creatorcontrib><creatorcontrib>Cole, L.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lederle, F. A.</au><au>Noorbaloochi, S.</au><au>Nugent, S.</au><au>Taylor, B. C.</au><au>Grill, J. P.</au><au>Kohler, T. R.</au><au>Cole, L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multicentre study of abdominal aortic aneurysm measurement and enlargement</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>2015-11</date><risdate>2015</risdate><volume>102</volume><issue>12</issue><spage>1480</spage><epage>1487</epage><pages>1480-1487</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Background
No effective treatment is currently available to prevent progression of small and medium‐sized abdominal aortic aneurysms (AAAs). Identification of drugs with sufficient promise to justify large expensive randomized trials remains challenging. One potentially useful strategy is to look for associations between commonly used drugs and AAA enlargement in appropriately adjusted observational studies.
Methods
Potential AAA measurements were identified from abdominal imaging reports in the electronic data files of three medical centres from 1995 to 2010. AAA measurements were extracted manually and patients with an aneurysm of 3 cm or larger, who had at least two measurements over an interval of at least 6 months, were identified. Other data were obtained from the electronic data files (demographics, co‐morbidities, smoking status, drug use) to conduct a propensity analysis of the associations of drugs and other factors with AAA enlargement.
Results
From 52 962 abdominal imaging studies, 5362 patients with an AAA of 3 cm or more were identified, of whom 2428 had at least two measurements over at least 6 months. Mean AAA follow‐up was 3·4 years and the mean AAA enlargement rate was 2·0 mm per year. Propensity analysis demonstrated no significant association of AAA enlargement with statins, beta‐blockers, angiotensin‐converting enzyme inhibitors or angiotensin II receptor blockers. Diabetes was associated with a reduction in AAA enlargement of 1·2 mm per year (P = 0·008), and chronic obstructive pulmonary disease was associated with increased enlargement (0·5 mm per year; P = 0·050). Moderate AAA measurement variation and substantial terminal digit preference were also observed, but the digit preference became less pronounced after 2000.
Conclusion
This study confirms the negative association of diabetes with AAA progression. There was no evidence that commonly used cardiovascular drugs affect AAA enlargement.
Nothing to reduce growth</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>26331269</pmid><doi>10.1002/bjs.9895</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | British journal of surgery, 2015-11, Vol.102 (12), p.1480-1487 |
| issn | 0007-1323 1365-2168 |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adrenergic beta-Antagonists - therapeutic use Aged Aneurysm, Ruptured - diagnosis Aneurysm, Ruptured - drug therapy Aneurysm, Ruptured - surgery Angiotensin-Converting Enzyme Inhibitors - therapeutic use Aortic Aneurysm, Abdominal - diagnosis Aortic Aneurysm, Abdominal - drug therapy Aortic Aneurysm, Abdominal - surgery Disease Progression Female Follow-Up Studies Humans Male Prognosis Retrospective Studies Risk Factors Severity of Illness Index Time Factors Tomography, X-Ray Computed - methods Ultrasonography, Doppler - methods Vascular Surgical Procedures - methods |
| title | Multicentre study of abdominal aortic aneurysm measurement and enlargement |
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