Thrombus volume is associated with cardiovascular events and aneurysm growth in patients who have abdominal aortic aneurysms

Golledge, Jonathan, Parr, Adam, McCann, Moira, Buttner, Petra, Bradshaw, Barbara, and UNSPECIFIED (2010) Thrombus volume is associated with cardiovascular events and aneurysm growth in patients who have abdominal aortic aneurysms. In: Journal of Vascular Surgery (51), 17S-17S. From: Vascular Annual Meeting of the Society for Vascular Surgery, 10-13 June 2010, Boston, MA, USA.

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Abstract

Objectives: The aims of this study were to prospectively assess the association of infra-renal abdominal aortic thrombus volume with cardiovascular events and abdominal aortic aneurysm (AAA) growth.

Methods: 98 patients with AAAs (median diameter 47.2 mm) underwent computed tomography angiography (CTA). The volume of thrombus in the infra-renal aorta was measured by a previously validated technique. Patients were followed prospectively for a median of 3 (inter-quartile range 2.0-3.6) years and cardiovascular events (nonfatal stroke, nonfatal myocardial infarction, coronary revascularization, amputation and cardiovascular death) recorded. 39 patients underwent repeat CTA a median of 1.5 (inter-quartile range 1.1-3.3) years later. Kaplan-Meier and Cox-proportional analysis were used to examine the association of aortic thrombus with cardiovascular events and average weighted AAA growth.

Results: A total of 28 cardiovascular event occurred during follow-up. The incidence of cardiovascular events was 23.4 and 49.2% for patients with small (< median) and large (≥median) volumes of aortic thrombus, respectively, at 4 years (p < 0.05). AAA thrombus volume ≥median was associated with increased cardiovascular events (RR 2.8, 95% CI 1.01- 5.24) independent of other risk factors including initial aortic diameter. In the sub-set of patients with CTA follow-up median annual increase in AAA volume was 5.1cm3 (inter-quartile range 0.8-10.3). Annual abdominal aortic volume change was positively correlated with maximal axial abdominal aortic diameter (r = 0.44, p = 0.006) and thrombus volume (r = 0.50, p = 0.001). Thrombus volume ≥median was associated with rapid volumetric growth (≥5 cm3/year), independent of initial aortic diameter (OR 15.0, 95% CI 1.9-115.7, p = 0.009).

Conclusions: AAA thrombus volume was independently associated with cardiovascular events and AAA progression. The mechanisms underlying these associations warrant further study in order to determine if anti-thrombotic therapies reduce outcome events.

Item ID: 23827
Item Type: Conference Item (Abstract / Summary)
Additional Information:

Published in Journal of Vascular Surgery, Volume 51, Issue 6, Supplement, Page 17S, June 2010.

ISSN: 1097-6809
Date Deposited: 31 Oct 2012 05:29
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1102 Cardiovascular Medicine and Haematology > 110201 Cardiology (incl Cardiovascular Diseases) @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 100%
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