¿Metformin to Treat Abdominal Aortic Aneurysms?

Currently, there are no drugs to treat abdominal aortic aneurysms (AAA) outside those indicated as secondary prevention drugs.  

El tratamiento endovascular parece superior a la cirugía en aneurismas rotosWhat this study shows is that diabetic patients treated with metformin had lower AAA incidence than diabetic patients treated without metformin, and even lower incidence than non- diabetic patients, as if metformin per se were a protective factor beyond diabetes. This undoubtedly calls for randomized studies with small AAA and evolution follow up.

 

The present observational and prospective study carried out in Australia included asymptomatic patients with unrepaired AAA of any diameter over 30 mm.


Read also: Several Features Define a Hostile Neck in AAA patients, but Only One Makes the Difference.


Primary end point was the need to repair AAA or AAA related mortality. The association between metformin and AAA related events was assessed using Kaplan Meier analysis and Cox proportional hazard analysis.

 

It included 1080 patients with an initial average diameter of 46.1 mm, followed up for mean 2.5 years.

 

Patients with a diabetes diagnosis in treatment with metformin presented lower AAA related events than non-diabetic patients (adjusted HR 0.63, CI 95% 0.44 to 0.93), while diabetics without metformin did not (adjusted HR 1.15, CI 95% CI 0.83 to 1.59).


Read also: Risk of Colonic Ischemia after Abdominal Aortic Aneurysm Repair.


Findings were similar when looking at patients with ≤50 mm initial diameters.

 

Conclusion

These findings set grounds for a future randomized study to determine the clinical importance of metformin in AAA patients, regardless diameter or the presence or absence of diabetes.

 

Original title: Metformin Prescription is Associated with a Reduction in the Combined Incidence of Surgical Repair and Rupture Related Mortality in Patients with Abdominal Aortic Aneurysm.

Reference: Jonathan Golledge et al. Eur J Vasc Endovasc Surg. 2019 Jan;57(1):94-101.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

More articles by this author

Endovascular Treatment of Iliofemoral Disease for the Improvement of Heart Failure with Preserved Ejection Fraction

Peripheral artery disease (PAD) is a significant risk factor in the development of difficult-to-treat conditions, such as heart failure with preserved ejection fraction (HFpEF)....

Chronic Thromboembolic Pulmonary Hypertension: Treatment Outcomes According to a Worldwide Registry

Chronic thromboembolic pulmonary hypertension (CTEPH) is a highly limiting condition that, despite its moderate incidence, significantly impacts patient prognosis and quality of life. The...

Contemporary Outcomes of Acute Limb Ischemia Endovascular Revascularization

Acute limb ischemia (ALI) is a vascular emergency with high mortality rate. It has been defined as a sudden occlusion of limb perfusion compromising...

TCT 2024 | SIRONA: Randomized Study Comparing Sirolimus-Coated vs Paclitaxel-Coated Balloon Angioplasty in Femoropopliteal Disease

This prospective, randomized, multicenter, investigator-initiated non-inferiority study compared the use of sirolimus-coated balloon (MagicTouch) vs paclitaxel-coated balloon in endovascular treatment.  The primary objective was to...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Endovascular Treatment of Iliofemoral Disease for the Improvement of Heart Failure with Preserved Ejection Fraction

Peripheral artery disease (PAD) is a significant risk factor in the development of difficult-to-treat conditions, such as heart failure with preserved ejection fraction (HFpEF)....