Alkhalfan Fahad, Hariri Essa, Aggarwal Anu, Burton Robert, Rajasekar Bhairavi, Scalise Alliefair, Chaudhury Pulkit, Fendrikova Mahlay Natalia, Owens A Phillip, Cameron Scott J
Section of Vascular Medicine, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA; Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner Research Institute of Case Western Reserve University, Cleveland, OH, USA.
Division of Cardiology, Johns Hopkins Medicine, Baltimore, MD, USA.
Am J Med. 2025 Jun 25. doi: 10.1016/j.amjmed.2025.06.040.
While risk factors for atherosclerotic diseases and abdominal aortic aneurysms overlap, some risk factors, like diabetes, may slow aneurysm growth. The impact of atherosclerosis and its treatment on aneurysm growth is unknown. We aimed to investigate whether atherosclerotic conditions and cardiovascular medications are associated with faster aneurysm growth.
Annualized abdominal aortic aneurysm growth rates were assessed over 10 years. The presence of coronary artery disease, peripheral artery disease, renal artery stenosis, and internal carotid artery stenosis was ascertained. Multivariable logistic regression models assessed the association between atherosclerotic conditions and fast aneurysm growth (≥0.5 cm/year). We further stratified by medication use, including aspirin.
Coronary artery disease, carotid artery stenosis, and renal artery stenosis were associated with reduced odds of fast aortic aneurysm growth, likely due to medications for treating these conditions. Aspirin was the only medication to show slower aneurysm growth regardless of disease co-morbidity. Patients with peripheral artery disease not managed by medications had faster aneurysm growth than those without peripheral artery disease. The addition of a Statin mediction was associated with a further reduction in fast aneurysm growth in patients with peripheral artery disease already taking aspirin.
Atherosclerosis in vascular beds outside of the aorta was associated with a lower risk of fast aneurysm growth. Peripheral artery disease without pharmacological therapy had higher rates of fast aneurysm growth. Aspirin showed decreased aneurysm growth regardless of the co-incident vascular disease in patients with abdominal aortic aneurysms, highlighting the importance of appropriate pharmacological therapy.
虽然动脉粥样硬化疾病和腹主动脉瘤的危险因素存在重叠，但某些危险因素，如糖尿病，可能会减缓动脉瘤的生长。动脉粥样硬化及其治疗对动脉瘤生长的影响尚不清楚。我们旨在研究动脉粥样硬化情况和心血管药物是否与动脉瘤更快生长有关。
评估10年间腹主动脉瘤的年化生长率。确定是否存在冠状动脉疾病、外周动脉疾病、肾动脉狭窄和颈内动脉狭窄。多变量逻辑回归模型评估动脉粥样硬化情况与快速动脉瘤生长（≥0.5厘米/年）之间的关联。我们进一步按药物使用情况进行分层，包括阿司匹林。
冠状动脉疾病、颈动脉狭窄和肾动脉狭窄与快速主动脉瘤生长几率降低有关，这可能是由于治疗这些疾病的药物所致。无论疾病合并情况如何，阿司匹林是唯一显示出动脉瘤生长较慢的药物。未接受药物治疗的外周动脉疾病患者的动脉瘤生长速度比没有外周动脉疾病的患者更快。对于已经服用阿司匹林的外周动脉疾病患者，加用他汀类药物与快速动脉瘤生长的进一步降低有关。
主动脉以外血管床的动脉粥样硬化与快速动脉瘤生长风险较低有关。未经药物治疗的外周动脉疾病患者快速动脉瘤生长率较高。无论腹主动脉瘤患者同时存在何种血管疾病，阿司匹林均显示出动脉瘤生长减缓，这突出了适当药物治疗的重要性。
