当前位置： SCI文献检索 > CIRCULATION期刊下所有文献 > Safety of Men With Small and Medium Abdominal Aortic Aneurysms Under Surveillance in the NAAASP.

Safety of Men With Small and Medium Abdominal Aortic Aneurysms Under Surveillance in the NAAASP.

Abstract：

BACKGROUND:Population screening for abdominal aortic aneurysm (AAA) has commenced in several countries, and has been shown to reduce AAA-related mortality by up to 50%. Most men who screen positive have an AAA <5.5 cm in diameter, the referral threshold for treatment, and are entered into an ultrasound surveillance program. This study aimed to determine the risk of ruptured AAA (rAAA) in men under surveillance. METHODS:Men in the National Health Service AAA Screening Programme who initially had a small (3-4.4 cm) or medium (4.5-5.4 cm) AAA were followed up. The screening program's database collected data on ultrasound AAA diameter measurements, dates of referral, and loss to follow-up. Local screening programs recorded adverse outcomes, including rAAA and death. Rupture and mortality rates were calculated by initial and final known AAA diameter. RESULTS:A total of 18 652 men were included (50 103 person-years of surveillance). Thirty-one men had rAAA during surveillance, of whom 29 died. Some 952 men died of other causes during surveillance, mainly cardiovascular complications (26.3%) and cancer (31.2%). The overall mortality rate was 1.96% per annum, similar for men with small and medium AAAs. The rAAA risk was 0.03% per annum (95% CI, 0.02%-0.05%) for men with small AAAs and 0.28% (0.17%-0.44%) for medium AAAs. The rAAA risk for men with AAAs just below the referral threshold (5.0-5.4 cm) was 0.40% (0.22%-0.73%). CONCLUSIONS:The risk of rAAA under surveillance is <0.5% per annum, even just below the present referral threshold of 5.5 cm, and only 0.4% of men under surveillance are estimated to rupture before referral. It can be concluded that men with small and medium screen-detected AAAs are safe provided they are enrolled in an intensive surveillance program, and that there is no evidence that the current referral threshold of 5.5 cm should be changed.

journal_name

Circulation

journal_title

Circulation

authors

Oliver-Williams C,Sweeting MJ,Jacomelli J,Summers L,Stevenson A,Lees T,Earnshaw JJ

doi

10.1161/CIRCULATIONAHA.118.036966

subject

Has Abstract

pub_date

2019-03-12 00:00:00

pages

1371-1380

issue

eissn

0009-7322

issn

1524-4539

journal_volume

139

pub_type

杂志文章

在线工具

Safety of Men With Small and Medium Abdominal Aortic Aneurysms Under Surveillance in the NAAASP.