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No increased mortality with early aortic aneurysm disease
- Source :
- Journal of Vascular Surgery. 56:1246-1251
- Publication Year :
- 2012
- Publisher :
- Elsevier BV, 2012.
-
Abstract
- Objective In addition to increased risks for aneurysm-related death, previous studies have determined that all-cause mortality in abdominal aortic aneurysm (AAA) patients is excessive and equivalent to that associated with coronary heart disease. These studies largely preceded the current era of coronary heart disease risk factor management, however, and no recent study has examined contemporary mortality associated with early AAA disease (aneurysm diameter between 3 and 5 cm). As part of an ongoing natural history study of AAA, we report the mortality risk associated with presence of early disease. Methods Participants were recruited from three distinct health care systems in Northern California between 2006 and 2011. Aneurysm diameter, demographic information, comorbidities, medication history, and plasma for biomarker analysis were collected at study entry. Survival status was determined at follow-up. Data were analyzed with t -tests or χ 2 tests where appropriate. Freedom from death was calculated via Cox proportional hazards modeling; the relevance of individual predictors on mortality was determined by log-rank test. Results The study enrolled 634 AAA patients; age 76.4 ± 8.0 years, aortic diameter 3.86 ± 0.7 cm. Participants were mostly male (88.8%), not current smokers (81.6%), and taking statins (76.7%). Mean follow-up was 2.1 ± 1.0 years. Estimated 1- and 3-year survival was 98.2% and 90.9%, respectively. Factors independently associated with mortality included larger aneurysm size (hazard ratio, 2.12; 95% confidence interval, 1.26-3.57 for diameter >4.0 cm) and diabetes (hazard ratio, 2.24; 95% confidence interval, 1.12-4.47). After adjusting for patient-level factors, health care system independently predicted mortality. Conclusions Contemporary all-cause mortality for patients with early AAA disease is lower than that previously reported. Further research is warranted to determine important factors that contribute to improved survival in early AAA disease.
- Subjects :
- Male
medicine.medical_specialty
Medication history
030204 cardiovascular system & hematology
030230 surgery
Article
03 medical and health sciences
Aortic aneurysm
0302 clinical medicine
Cause of Death
Internal medicine
medicine
Humans
Prospective Studies
Survival rate
Aged
Cause of death
business.industry
Proportional hazards model
Hazard ratio
medicine.disease
Abdominal aortic aneurysm
Confidence interval
3. Good health
Surgery
Survival Rate
Female
Cardiology and Cardiovascular Medicine
business
Aortic Aneurysm, Abdominal
Subjects
Details
- ISSN :
- 07415214
- Volume :
- 56
- Database :
- OpenAIRE
- Journal :
- Journal of Vascular Surgery
- Accession number :
- edsair.doi.dedup.....d1e39e0226999222de60894f0acb79a0