[HTML][HTML] Does EVAR alter the rate of cardiovascular events in patients with abdominal aortic aneurysm considered unfit for open repair? Results from the randomised …
LC Brown, RM Greenhalgh, SG Thompson… - European Journal of …, 2010 - Elsevier
LC Brown, RM Greenhalgh, SG Thompson, JT Powell
European Journal of Vascular and Endovascular Surgery, 2010•ElsevierOBJECTIVES: To investigate whether EndoVascular Aneurysm Repair (EVAR) influences
the rate of cardiovascular events (fatal or non-fatal myocardial infarction or stroke) in patients
with abdominal aortic aneurysm (AAA) considered unfit for open repair. DESIGN:
Randomised controlled trial. MATERIALS: Between 1999 and 2004, 404 patients with large
AAA considered unfit for open repair were randomised to EVAR or no surgical intervention
across 33 UK hospitals and followed until July 2009. METHODS: The Customised …
the rate of cardiovascular events (fatal or non-fatal myocardial infarction or stroke) in patients
with abdominal aortic aneurysm (AAA) considered unfit for open repair. DESIGN:
Randomised controlled trial. MATERIALS: Between 1999 and 2004, 404 patients with large
AAA considered unfit for open repair were randomised to EVAR or no surgical intervention
across 33 UK hospitals and followed until July 2009. METHODS: The Customised …
OBJECTIVES
To investigate whether EndoVascular Aneurysm Repair (EVAR) influences the rate of cardiovascular events (fatal or non-fatal myocardial infarction or stroke) in patients with abdominal aortic aneurysm (AAA) considered unfit for open repair.
DESIGN
Randomised controlled trial.
MATERIALS
Between 1999 and 2004, 404 patients with large AAA considered unfit for open repair were randomised to EVAR or no surgical intervention across 33 UK hospitals and followed until July 2009.
METHODS
The Customised Probability Index was used to determine fitness for each patient and Cox regression was used to compare time to first cardiovascular event between randomised groups and levels of fitness.
RESULTS
During an average of 2.8 years of follow-up, 67 first cardiovascular events occurred with a non-significantly higher event rate in the EVAR group compared to the no intervention group (6.6 versus 5.1 events per 100 person years); adjusted hazard ratio 1.42 [95% CI 0.87–2.34], p=0.156. There was no evidence to suggest that the hazard ratio between randomised groups changed with level of fitness (p=0.378).
CONCLUSIONS
Cardiovascular event rates were high in these unfit patients and medical therapy was sub-optimal. Events rates were slightly higher in the EVAR group but this was not statistically significant.
Elsevier
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