title: A retrospective study: Factors associated with the risk of abdominal aortic aneurysm rupture.
abstract: BACKGROUND
  Literature regarding pharmacological manipulation of aneurysm development and progression is abundant; however studies looking at preventing rupture are sparse. Moreover, best medical therapy is ill-instituted, and continued in this high-risk cohort. This paper aims to identify factors which affect the risk of AAA-rupture.
  
  
  METHODS
  A retrospective review of patients undergoing non-screen detected AAA-repair at a single tertiary-referral centre was performed. Age, cardiovascular history, medication use and the nature of surgical repair (elective or emergency) were converted to binary characteristics and a binomial logistic regression performed.
  
  
  RESULTS
  We included 315 admissions for ruptured AAA, and 668 referrals for elective repair of large aneurysms (n=983). Multifactorial analysis showed that the cohort which was prescribed statins experienced fewer ruptured AAA ([OR] 0.50, [95% CI] 0.32-0.77). Factors associated with increased risk of rupture include female gender (2.49, 1.63-3.80), history of hypertension (3.5, 1.6-3.8) or renal failure (8.08, 4.15-15.4), age over 80 (2.77, 1.79-4.27) and current smoking (1.80, 1.09-2.96).
  
  
  CONCLUSIONS
  This is the largest study, interrogating individual patient data, to suggest an association between statins and prevention of large AAA-rupture. As patients with AAA are at high risk of cardiovascular events, and statins may decrease the risk of the devastating consequence of the condition, healthcare teams should maintain pharmaco-vigilance in instituting and continuing best medical therapy, including a statin.
authors.affiliation: NIHR, Leicester Cardiovascular Biomedical Research Unit, BHF Cardiovascular Research Centre, Glenfield Hospital, Leicester, LE3 9QP, United Kingdom. Electronic address: vimal.gokani@gmail.com.
authors.forename: V J
authors.initials: VJ
authors.lastname: Gokani
authors.affiliation: NIHR, Leicester Cardiovascular Biomedical Research Unit, BHF Cardiovascular Research Centre, Glenfield Hospital, Leicester, LE3 9QP, United Kingdom.
authors.forename: D
authors.initials: D
authors.lastname: Sidloff
authors.affiliation: NIHR, Leicester Cardiovascular Biomedical Research Unit, BHF Cardiovascular Research Centre, Glenfield Hospital, Leicester, LE3 9QP, United Kingdom.
authors.forename: M F
authors.initials: MF
authors.lastname: Bath
authors.affiliation: NIHR, Leicester Cardiovascular Biomedical Research Unit, BHF Cardiovascular Research Centre, Glenfield Hospital, Leicester, LE3 9QP, United Kingdom.
authors.forename: M J
authors.initials: MJ
authors.lastname: Bown
authors.affiliation: NIHR, Leicester Cardiovascular Biomedical Research Unit, BHF Cardiovascular Research Centre, Glenfield Hospital, Leicester, LE3 9QP, United Kingdom.
authors.forename: R D
authors.initials: RD
authors.lastname: Sayers
authors.affiliation: NIHR, Leicester Cardiovascular Biomedical Research Unit, BHF Cardiovascular Research Centre, Glenfield Hospital, Leicester, LE3 9QP, United Kingdom.
authors.forename: E
authors.initials: E
authors.lastname: Choke
mesh_terms: D000367:Age Factors; D017544:Aortic Aneurysm, Abdominal / Q000209:etiology* / Q000517:prevention & control / Q000601:surgery; D001019:Aortic Rupture / Q000209:etiology* / Q000517:prevention & control / Q000601:surgery; D016208:Databases, Factual; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D004638:Emergency Treatment / Q000706:statistics & numerical data; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D006973:Hypertension / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D014656:Vascular Surgical Procedures / Q000379:methods
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: AAA rupture risk; Risk factor; Statin therapy