Association of metformin use with abdominal aortic aneurysm: A systematic review and meta-analysis.

BACKGROUND

Abdominal aortic aneurysm (AAA) is a cardiovascular disease characterized by a high mortality rate when ruptured. Some studies suggest a potential inverse correlation between AAA and diabetes patients, especially those undergoing metformin treatment. However, this relationship remains unclear. This paper offers a systematic review and meta-analysis with the objective of clarifying the influence of metformin on AAA.

METHODS

A search for relevant articles was performed across multiple databases including PubMed, ScienceDirect, Cochrane and Scopus. The focus was on studies that examined the comparative effects of metformin and non-metformin treatments on AAA patients. Data from appropriate studies were consolidated to estimate the effects. Our study encompassed 11 articles, comprising 13 cohorts that compared metformin ( = 32,250) with a control group ( = 116,339).

RESULTS

The random effects meta-analysis revealed that metformin was associated with a slower growth rate (weighted mean difference (WMD) -0.86 mm; 95% CI: -1.21 to -0.52;  < 0.01; I: 81.4%) and fewer AAA-related events (OR: 0.54; 95% CI: 0.34 to 0.86;  = 0.01; I: 60.9%). The findings suggest that metformin may be linked to a reduced risk of aortic aneurysm. A meta-regression analysis indicated that the association between metformin and AAA growth was significantly influenced by male gender ( = 0.027), but not by age ( = 0.801), hypertension ( = 0.256), DM ( = 0.689), smoking history ( = 0.786), use of lipid-lowering agents ( = 0.715), or baseline diameter ( = 0.291).

CONCLUSION

These results hint at a potential role for metformin in limiting annual AAA growth, AAA-related events, and the risk of AAA.