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

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.