Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, Australian Institute of Tropical Medicine, James Cook University, Townsville, QLD, 4811, Australia.
The Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, QLD, Australia.
Sci Rep. 2020 Sep 3;10(1):14583. doi: 10.1038/s41598-020-71454-4.
The aims of this study were, firstly, to assess the effect of concurrent peripheral artery disease (PAD) on the health-related quality of life (QOL) of people diagnosed with a small abdominal aortic aneurysm (AAA); and secondly, to test whether the peroxisome proliferator-activated receptor α agonist fenofibrate improved QOL of people diagnosed with a small AAA, including those diagnosed with concurrent PAD. The study included both a cross-sectional observational study and a randomized placebo-controlled clinical trial. 140 people diagnosed with a 35-49 mm diameter AAA, 56 (40%) of whom had concurrent PAD, and 25 healthy controls were prospectively recruited. QOL was assessed with the short form (SF) 36. Findings in participants that were diagnosed with both AAA and PAD were compared separately with those of participants that had a diagnosis of AAA alone or who had neither AAA nor PAD diagnosed (healthy controls). All participants diagnosed with an AAA were then randomly allocated to 145 mg of fenofibrate per day or identical placebo. Outcomes were assessed by changes in the domains of the SF-36 and ankle brachial pressure Index (ABPI) from randomization to 24 weeks. Data were analyzed using Mann-Whitney U tests. Participants diagnosed with both AAA and PAD had significantly worse QOL than participants diagnosed with AAA alone or healthy controls. Fenofibrate did not significantly alter SF-36 scores or ABPI over 24 weeks. Fenofibrate does not improve QOL of people diagnosed with small AAA, irrespective of whether they have concurrent PAD.Trial registration: ACTN12613001039774 Australian New Zealand Clinical Trials Registry.
本研究的目的首先是评估同时患有外周动脉疾病(PAD)对诊断为小腹主动脉瘤(AAA)患者的健康相关生活质量(QOL)的影响;其次,测试过氧化物酶体增殖物激活受体α激动剂非诺贝特是否改善了诊断为小 AAA 的患者的生活质量,包括同时患有 PAD 的患者。该研究包括横断面观察性研究和随机安慰剂对照临床试验。前瞻性招募了 140 名诊断为 35-49mm 直径 AAA 的患者,其中 56 名(40%)同时患有 PAD,25 名健康对照者。采用简短形式(SF)36 评估生活质量。分别比较了同时患有 AAA 和 PAD 的患者与仅患有 AAA 的患者或未被诊断为 AAA 或 PAD 的患者(健康对照组)的发现。所有被诊断为 AAA 的患者随后被随机分配到每天服用 145 毫克非诺贝特或相同的安慰剂。通过从随机分组到 24 周时 SF-36 和踝肱血压指数(ABPI)的变化来评估结果。使用 Mann-Whitney U 检验分析数据。同时患有 AAA 和 PAD 的患者的生活质量明显差于仅患有 AAA 的患者或健康对照组。在 24 周内,非诺贝特并未显著改变 SF-36 评分或 ABPI。非诺贝特不能改善诊断为小 AAA 的患者的生活质量,无论他们是否同时患有 PAD。试验注册:ACTRN12613001039774 澳大利亚和新西兰临床试验注册处。