Management of Modifiable Vascular Risk Factors Improves Late Survival following Abdominal Aortic Aneurysm Repair: A Systematic Review and Meta-Analysis

Khashram, Manar; Williman, Jonathan; Hider, Phil; Jones, Gregory T.; Roake, Justin

doi:10.1016/j.avsg.2016.07.066

“…A recent review of literature proves an increased cumulative long-term survival after open and endovascular repair from adequate cardiovascular risk management. 13 Nonetheless, a population-based Medicare study describing survival after open and endovascular repair in the same time frame as the DREAM trial showed overall survival rates after 8 years in the range of 45%, whereas it is roughly 60% in the DREAM trial cohort. 14,15 Although a propensity score matching was performed in this Medicare study, the fact that all patients in the DREAM trial were suitable for both open and endovascular repair may be responsible for a better initial surgical risk and therefore better long-term overall survival.…”

Section: Discussionmentioning

confidence: 99%

Long-term survival and secondary procedures after open or endovascular repair of abdominal aortic aneurysms

Schaik¹,

Yeung²,

Verhagen³

et al. 2017

Journal of Vascular Surgery

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“…26 The use of statin therapy following aneurysm repair has also been shown to improve survival with a hazard ratio (HR) of 0.75 (95% confidence interval [CI]: 0.70-0.80). 27 Nevertheless, statin prescription rates in our cohort remained at only 61.5% (with the vast majority of these patients not on a high dose statin) and only 41.0% of patients with no other cardiovascular risk factors were taking a statin, even though they had been referred for an arterial disorder.…”

Section: Discussionmentioning

confidence: 66%

Cardiovascular risk reduction in referrals to outpatient vascular clinics

Stather

¹

,

Muscara

²

2018

annals

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Introduction Patients with peripheral arterial disease (PAD), aneurysmal disease (AD) or carotid atherosclerosis are at high cardiovascular risk, necessitating secondary cardiovascular protection. The aim of this study was to determine compliance with cardiovascular risk reduction guidelines in new patients referred to vascular clinics. Methods A multicentre collaborative national observational audit of new patients referred to eight tertiary general vascular clinics over a three-month period in England and Wales was conducted by the Vascular and Endovascular Research Network (VERN). Referral letters, case notes and investigations were reviewed by local investigators, and data analysed by VERN. Results A total of 656 patients were included in the study: 73.2% had PAD, 23.2% had AD and 3.7% had carotid atherosclerosis. A third (37.5%) were current smokers, two-thirds (61.7%) were on antiplatelet therapy and two-thirds (61.5%) were on statin therapy. Smoking was more prevalent in the PAD cohort (PAD 41.4%, AD 27.5%, p=0.003). However, more PAD patients were on antiplatelet therapy (PAD 63.9%, AD 53.3%, p=0.024). Both antiplatelet and statin prescription significantly increased with the number of cardiovascular risk factors. Patients with a previous cardiac or cerebrovascular history were more likely to have stopped smoking, and to be on antiplatelet and statin therapy (p<0.0001 for each). Overall, 47.3% of patients were on both antiplatelet and statin therapy, and 28.9% were on antiplatelet and statin therapy and not smoking. Conclusions This study highlights deficiencies in cardiovascular risk minimisation in patients with established vascular disease. Patients with concomitant cardiac or cerebrovascular disease were more likely to be on best medical therapy

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“…A recent review of literature proves an increased cumulative long-term survival after open and endovascular repair from adequate cardiovascular risk management. 13 Nonetheless, a population-based Medicare study describing survival after open and endovascular repair in the same time frame as the DREAM trial showed overall survival rates after 8 years in the range of 45%, whereas it is roughly 60% in the DREAM trial cohort. 14,15 Although a propensity score matching was performed in this Medicare study, the fact that all patients in the DREAM trial were suitable for both open and endovascular repair may be responsible for a better initial surgical risk and therefore better long-term overall survival.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Survival and Secondary Procedures after Open or Endovascular Repair of Abdominal Aortic Aneurysms

Jiménez¹,

Wilson²

2020

50 Landmark Papers Every Vascular and Endovascular Surgeon Should Know

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Management of Modifiable Vascular Risk Factors Improves Late Survival following Abdominal Aortic Aneurysm Repair: A Systematic Review and Meta-Analysis

Cited by 25 publications

References 37 publications

Long-term survival and secondary procedures after open or endovascular repair of abdominal aortic aneurysms

Long-term survival and secondary procedures after open or endovascular repair of abdominal aortic aneurysms

Cardiovascular risk reduction in referrals to outpatient vascular clinics

Long-Term Survival and Secondary Procedures after Open or Endovascular Repair of Abdominal Aortic Aneurysms

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