A retrospective study: Factors associated with the risk of abdominal aortic aneurysm rupture

IntroductionLiterature regarding pharmacological manipulation of aneurysm development and progression is abundant; however studies looking at preventing rupture are sparse. Moreover, best medical therapy is ill-instituted, and continued in this high-risk cohort. This paper aims to identify factors which affect the risk of AAA-rupture.Materials & methodsA retrospective review of patients undergoing non-screen detected AAA-repair at a single tertiary-referral centre was performed. Age, cardiovascular history, medication use and the nature of surgical repair (elective or emergency) were converted to binary characteristics and a binomial logistic regression performed.ResultsWe included 315 admissions for ruptured AAA, and 668 referrals for elective repair of large aneurysms (n = 983). Multifactorial analysis showed that the cohort which was prescribed statins experienced fewer ruptured AAA ([OR] 0.50, [95% CI] 0.32–0.77). Factors associated with increased risk of rupture include female gender (2.49, 1.63–3.80), history of hypertension (3.5, 1.6–3.8) or renal failure (8.08, 4.15–15.4), age over 80 (2.77, 1.79–4.27) and current smoking (1.80, 1.09–2.96).Discussion and conclusionsThis is the largest study, interrogating individual patient data, to suggest an association between statins and prevention of large AAA-rupture. As patients with AAA are at high risk of cardiovascular events, and statins may decrease the risk of the devastating consequence of the condition, healthcare teams should maintain pharmaco-vigilance in instituting and continuing best medical therapy, including a statin.

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