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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2001;21:1203.)
© 2001 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Aortic Aneurysm Diameter and Risk of Cardiovascular Mortality

Anthony R. Brady; F. Gerald R. Fowkes; Simon G. Thompson; Janet T. Powell

From MRC Clinical Trials Unit (A.R.B.), London, UK; the Department of Public Health Sciences (F.G.R.F.), University of Edinburgh, UK; MRC Biostatistics Unit (S.G.T.), Cambridge, UK; and the University Hospitals of Coventry and Warwickshire (J.T.P.), Coventry, UK.

Correspondence to Mr A.R. Brady, MRC Clinical Trials Unit, 222 Euston Rd, London NW1 2DA, UK. E-mail tbrady{at}ctu.mrc.ac.uk

Abstract—After successful surgical repair of an abdominal aortic aneurysm, patients have for many years an increased risk of death from cardiovascular causes. We have tested the hypothesis that for patients with abdominal aortic aneurysms, the risk of nonaneurysm cardiovascular mortality before and after surgery increased with aneurysm diameter. Records of aneurysm repair or rupture and mortality were available from 2305 patients entered into the UK Small Aneurysm Trial and Study. Two hundred fifty-nine deaths occurred before aneurysm repair or rupture (mean follow-up 1.7 years), and 325 occurred after surgical repair (mean follow-up 3.6 years). The risk of nonaneurysm-related mortality and cardiovascular death before and after surgery increased with aneurysm diameter at baseline, even after adjustment for other known risk factors. The adjusted hazard ratios for cardiovascular mortality, per standard deviation (0.8-cm) increase in aneurysm diameter, were 1.34 (95% CI 1.01 to 1.79) and 1.31 (95% CI 1.06 to 1.63) in the periods before aneurysm repair or rupture and after aneurysm repair, respectively. The significant association between aortic diameter and cardiovascular mortality, excluding aneurysm-related deaths, suggests that aneurysm diameter is an independent marker of cardiovascular disease risk.

Key Words: aneurysm • aorta • survival

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