Department of Clinical Medicine, Faculty of Health, Aalborg Thrombosis Research Unit, Aalborg University, Sdr. Skovvej 15, 9000 Aalborg, Denmark.
Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
Eur J Prev Cardiol. 2022 Nov 8;29(15):1957-1964. doi: 10.1093/eurjpc/zwac105.
Abdominal aortic aneurysmal disease is associated with increased risk of cardiovascular morbidity and death, which potentially can be reduced with cardioprotective medical therapy. The aim of this study was to observe temporal trends in prevalence and incidence of cardiovascular comorbidity as well as use of medical cardioprotective treatment in patients diagnosed with abdominal aortic aneurysmal disease.
This was a population-based cohort study based on data from national health registries, including all patients diagnosed with abdominal aortic aneurysms between 1998 and 2018. Data were stratified into four time periods (1999-2003, 2004-2008, 2009-2013, and 2014-2018) to illustrate trends over time. Outcome measures were (i) cardiovascular comorbidity and medical cardioprotective therapy at time of diagnosis, (ii) new admissions for atherosclerotic cardiovascular disease, and (iii) all-cause mortality after 2-year follow-up. The study cohort included 33 296 individuals. Mean age was 74 years. Prevalence of atherosclerotic cardiovascular comorbidity at diagnosis decreased from 41.5 to 32.6%. Use of statins increased from 17.9 to 66.9%, antiplatelets from 45.6 to 63.3%, and combined therapy with both antiplatelets and statins from 11.3 to 44.8%, and from 12.1 to 50.7% when anticoagulant therapy was included. Developments in medication use plateaued after 2013. Prevalence and incidence of atherosclerotic cardiovascular disease decreased through all four time periods. The same applied to all-cause mortality, which decreased from 24.3 to 12.4 deaths (per 100 person-years).
In patients diagnosed with abdominal aortic aneurysm, cardiovascular comorbidity at diagnosis, risk of future cardiovascular events, and all-cause mortality is decreasing. Nevertheless, cardiovascular burden and mortality rates remain substantial, and medical cardioprotective therapy can be further improved.
腹主动脉瘤疾病与心血管发病率和死亡率的增加相关，而这种风险可能可以通过心脏保护的医学治疗来降低。本研究的目的是观察心血管合并症的患病率和发病率以及诊断为腹主动脉瘤疾病患者的心脏保护药物治疗的使用随时间的变化趋势。
这是一项基于国家健康登记数据的基于人群的队列研究，包括 1998 年至 2018 年间诊断为腹主动脉瘤的所有患者。数据分为四个时间段（1999-2003、2004-2008、2009-2013 和 2014-2018）以说明随时间的变化趋势。结果指标为：（i）诊断时的心血管合并症和心脏保护治疗，（ii）动脉粥样硬化性心血管疾病的新入院，和（iii）2 年随访后的全因死亡率。研究队列包括 33296 名个体。平均年龄为 74 岁。诊断时动脉粥样硬化性心血管合并症的患病率从 41.5%下降到 32.6%。他汀类药物的使用率从 17.9%增加到 66.9%，抗血小板药物从 45.6%增加到 63.3%，联合使用抗血小板药物和他汀类药物的比例从 11.3%增加到 44.8%，如果包括抗凝治疗，则从 12.1%增加到 50.7%。药物使用的发展在 2013 年后趋于平稳。所有四个时间段的动脉粥样硬化性心血管疾病的患病率和发病率均下降。全因死亡率也是如此，从 24.3 例死亡（每 100 人年）降至 12.4 例死亡。
在诊断为腹主动脉瘤的患者中，诊断时的心血管合并症、未来心血管事件的风险和全因死亡率正在下降。尽管如此，心血管负担和死亡率仍然很高，心脏保护药物治疗可以进一步改善。
