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A Systematic Review and Meta-Analysis of the Incidence and Risk Factors for Major Adverse Cardiovascular Events in

Chinmay Sharma1, Tejas P Singh2, Shivshankar Thanigaimani1,3

  • 1Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia.

Biomedicines
|May 16, 2023
PubMed

Insights

Patients with unrepaired abdominal aortic aneurysms (AAA) face a high risk of major adverse cardiovascular events (MACE). Preventative medication use is suboptimal, highlighting the need for enhanced secondary prevention strategies in this vulnerable group.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Surgery
  • Epidemiology

Background:

  • Major adverse cardiovascular events (MACE), encompassing myocardial infarction (MI), stroke, and cardiovascular death, contribute significantly to morbidity and mortality.
  • Abdominal aortic aneurysm (AAA) is a serious vascular condition associated with increased cardiovascular risk.

Purpose of the Study:

  • To assess the incidence rate of MACE in patients with unrepaired AAA.
  • To examine the association of MACE with modifiable risk factors and medication use (aspirin, statins) in this population.

Main Methods:

  • Systematic review and meta-analysis of observational studies.
  • Inclusion of studies reporting incidence of MI, stroke, or cardiovascular death in patients with unrepaired AAAs.
  • Primary outcome: cardiovascular death incidence rate (events per 100 person-years).

Main Results:

  • Fourteen studies with 69,579 participants (mean follow-up 5.4 years) were included.
  • Incidence rates per 100 person-years: cardiovascular death (2.31), MI (1.65), and stroke (0.89).
  • Mean statin and aspirin prescription rates were 58.1% and 53.5%, respectively, indicating suboptimal use.

Conclusions:

  • Patients with unrepaired AAA experience a substantial incidence of MACE.
  • The prescription rates for secondary preventative medications like statins and aspirin are suboptimal in this cohort.
  • There is a critical need to enhance secondary prevention efforts for patients with unrepaired AAA.

Keywords:
abdominal aortic aneurysmcardiovascular deathmyocardial infarctionstroke

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