Aspirin may slow the progression of abdominal aortic aneurysm

1. In a retrospective cohort of 3435 adults, the progression of abdominal aortic aneurysm (AAA) slowed significantly for those taking aspirin compared to those not taking aspirin. 

2. Composite rates of rupture, repair, and dissection did not differ over a 10-year period. 

Evidence Rating Level: 2 (Good)

AAA is a relatively common cardiovascular cause of mortality, and although risk factors for the condition are established, very few pharmacotherapies have been established in decreasing risk of rupture and limiting its progression. However, preclinical studies have raised questions as to whether biomechanical platelet activation in disturbed flow environments are pathophysiologic in AAA. The current retrospective cohort study sought to investigate the association of aspirin, an antiplatelet therapy, with AAA long-term outcomes. A total of 3435 adults’ medical records (mean [SD] age 73.7 [9.0] years; 77.5% men) were reviewed to assess aspirin use/dosage as it relates to AAA diameter, the need for repair or dissection, and survival. All-cause mortality, major bleeds, and composite outcomes of dissection, rupture, or repair after ten years between patients taking aspirin and not taking aspirin did not differ significantly (ps > .05). However, aspirin use was found to be associated with slower progression of AAA annually (2.8 vs 3.8 mm per year; p = .001). The relationship between aspirin use and slowed progression remained significant for non-smokers and makes (Ps for interactions < .05). Aspiring was additionally not associated with more adverse events than non-aspirin use in this cohort (p > .05). These findings may suggest that aspirin could be beneficial in slowing AAA progression, particularly for specific patient groups. However, further prospective research that takes specific precautions to control for the variability in ultrasonography measurements should be considered.

Click to read the study in JAMA Network Open

Image: PD

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