Meta-analysis of the association between peripheral artery disease and growth of abdominal aortic aneurysms

Matthews, E.O., Rowbotham, S.E., Moxon, J.V., Jones, R.E., Vega de Ceniga, M., and Golledge, J. (2017) Meta-analysis of the association between peripheral artery disease and growth of abdominal aortic aneurysms. British Journal of Surgery, 104 (13). pp. 1765-1774.

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Background: The role of atherosclerosis in the pathogenesis of abdominal aortic aneurysm (AAA) is controversial. Atherosclerosis-associated peripheral artery disease (PAD) has been reported to be a risk factor for AAA in population screening studies; its relationship with AAA growth is controversial.

Methods: A systematic search of MEDLINE, Scopus, CINAHL and the Cochrane Central Register of Controlled Trials was conducted in April 2016 and repeated in January 2017. Databases were screened for studies reporting AAA growth rates in patients with, and without PAD. The included studies underwent quality assessment and, where possible, were included in the meta-analysis. A subgroup analysis was performed, including only studies that adjusted for confounding factors.

Results: Seventeen studies, including a total of 4873 patients, met the review entry criteria. Data from 15 studies were included in the meta-analysis. There was marked heterogeneity in study design, methodology and statistical analyses used. In the main analysis, PAD was associated with reduced AAA growth (mean difference – 0·13, 95 per cent c.i. –0·27 to –0·00; P = 0·04). However, statistical significance was not maintained in sensitivity analysis. In a subanalysis that included only data adjusted for other risk factors, no significant association between PAD and AAA growth was found (mean difference –0·11, –0·23 to 0·00; P = 0·05).

Conclusion: This systematic review suggests that currently reported studies demonstrate no robust and consistent association between PAD and reduced AAA growth.

Item ID: 51716
Item Type: Article (Research - C1)
ISSN: 1365-2168
Funders: National Health and Medical Research Council of Australia (NHMRC)
Projects and Grants: NHMRC 1098717, NHMRC 1079369, NHMRC 1079193, NHMRC 1022752, NHMRC 1000967, NHMRC 1117601
Date Deposited: 06 Dec 2017 07:34
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3201 Cardiovascular medicine and haematology > 320101 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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