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Multi-Centre Study on Cardiovascular Risk Management on Patients Undergoing AAA Surveillance.

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Patients with small abdominal aortic aneurysms (AAA) often lack crucial cardiovascular risk reduction treatments like statins and antiplatelets, and many continue to smoke, increasing their risk of events.

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Area of Science:

  • Vascular Surgery
  • Cardiovascular Medicine
  • Public Health Screening

Background:

  • Patients with abdominal aortic aneurysms (AAA) face a high risk of cardiovascular events and mortality.
  • Cardiovascular risk modification is critical for patient outcomes post-AAA diagnosis, alongside surveillance.
  • This study focuses on assessing cardiovascular risk reduction strategies in patients with small AAA.

Purpose of the Study:

  • To evaluate the extent of cardiovascular risk reduction in patients diagnosed with small abdominal aortic aneurysms.
  • To identify gaps in the management of cardiovascular risk factors in this patient population.
  • To assess current protocols for cardiovascular protection within AAA screening programs.

Main Methods:

  • Retrospective data collection from four English tertiary vascular units for patients with small AAA (2013-2015).
  • Analysis of demographic details, medications (antiplatelets, statins), and smoking status.
  • Secondary analysis involved surveying AAA screening units in England and Wales regarding their CV protection protocols.

Main Results:

  • 1053 male patients (mean age 74) with small AAA were included.
  • Only 63.2% received both antiplatelet and statin therapy; 32.1% were current smokers.
  • Less than half (48.1%) achieved optimal risk reduction (statin, antiplatelet, and smoking cessation).
  • While most screening units suggest prescription changes, none monitor compliance or GP notification.

Conclusions:

  • A significant proportion of small AAA patients are undertreated with essential cardiovascular medications and continue to smoke.
  • This leads to a persistent high risk of cardiovascular morbidity and mortality.
  • There is a lack of national guidance to ensure adequate cardiovascular protection for this high-risk group.