The Protective Effects of Diabetes Mellitus on Post-EVAR AAA Growth and Reinterventions

Png, C.Y. Maximilian; Tadros, Rami O.; Kang, Ming; Beckerman, William E.; Tardiff, Melissa; Vouyouka, Ageliki G.; Marin, Michael L.; Faries, Peter L.

doi:10.1016/j.avsg.2016.10.059

Cited by 21 publications

(13 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Higher rates of complications such as myocardial infarction, infection, or pancreatitis were observed in diabetic patients after AAA open repair, 22 and higher incidence of device-related complications following endovascular AAA repair were found. 21 On the opposite, DM had a protective effect on AAA growth and re-interventions after endovascular repair, 23 but no significant difference in the occurrence of neck dilatation or type 1 endoleaks was identified between diabetics and controls. 24 …”

Section: Diabetes and The Epidemiology Of Aortic Aneurysmmentioning

confidence: 96%

Diabetes and aortic aneurysm: current state of the art

Raffort

Lareyre

Clément

et al. 2018

Cardiovascular Research

135

102

View full text Add to dashboard Cite

Aortic aneurysm is a life-threatening disease due to the risk of aortic rupture. The only curative treatment available relies on surgical approaches; drug-based therapies are lacking, highlighting an unmet need for clinical practice. Abdominal aortic aneurysm (AAA) is frequently associated with atherosclerosis and cardiovascular risk factors including male sex, age, smoking, hypertension, and dyslipidaemia. Thoracic aortic aneurysm (TAA) is more often linked to genetic disorders of the extracellular matrix and the contractile apparatus but also share similar cardiovascular risk factors. Intriguingly, a large body of evidence points to an inverse association between diabetes and both AAA and TAA. A better understanding of the mechanisms underlying the negative association between diabetes and aortic aneurysm could help the development of innovative diagnostic and therapeutic approaches to tackle the disease. Here, we summarize current knowledge on the relationship between glycaemic parameters, diabetes, and the development of aortic aneurysm. Cellular and molecular pathways that underlie the protective effect of diabetes itself and its treatment are reviewed and discussed, along with their potential implications for clinical translation.

show abstract

Section: Diabetes and The Epidemiology Of Aortic Aneurysmmentioning

confidence: 96%

Diabetes and aortic aneurysm: current state of the art

Raffort

Lareyre

Clément

et al. 2018

Cardiovascular Research

135

102

View full text Add to dashboard Cite

show abstract

“…14 These demographic factors each have a documented effect on outcomes after EVAR, and the cumulative effect of this variation among baseline characteristics is difficult to quantify. [15][16][17] The mean preoperative aneurysm diameter was 5.8 cm in our cohort and ranged from 5.6 to 6.5 cm in the trials included in the meta-analysis. 1,10 This difference in baseline aneurysm size may have contributed to the lower rates of ARM and delayed rupture in our cohort than were observed in the clinical trials.…”

mentioning

confidence: 91%

Long-term freedom from aneurysm-related mortality remains favorable after endovascular abdominal aortic aneurysm repair in a 15-year multicenter registry

Rich

Tucker

Okuhn

et al. 2020

Journal of Vascular Surgery

View full text Add to dashboard Cite

“…Such complications were not assessed in this study, but might perhaps arise less often in patients with DM; in a large cohort of 1479 patients, DM was shown to be associated with a decrease in aneurysm sac enlargement and a lower need for reintervention after EVAR. 33 However, in a recent meta-analysis of 24 studies with 14,754 patients, no association between DM and sac shrinkage after EVAR was found. 34 AAA, abdominal aortic aneurysm; AMI, acute myocardial infarction.…”

Section: Discussionmentioning

confidence: 96%

Survival, cardiovascular morbidity, and reinterventions after elective endovascular aortic aneurysm repair in patients with and without diabetes: A nationwide propensity-adjusted analysis

Taimour

Avdic²,

Franzén³

et al. 2019

Vasc Med

View full text Add to dashboard Cite

Epidemiological data indicate decreased risk for development and growth of abdominal aortic aneurysm (AAA) among patients with diabetes mellitus (DM). On the other hand, DM adds to increased cardiovascular (CV) morbidity and mortality. In a nationwide observational cohort study of patients registered in the Swedish Vascular Register and the Swedish National Diabetes Register, we evaluated potential effects of DM on total mortality, CV morbidity, and the need for reintervention after elective endovascular aneurysm repair (EVAR) for AAA. We compared 748 patients with and 2630 without DM with propensity score-adjusted analysis, during a median 4.22 years of follow-up for patients with DM, and 4.05 years for those without. In adjusted analysis, diabetic patients showed higher rates of acute myocardial infarction (AMI) during follow-up (relative risk (RR) 1.44, 95% CI 1.06–1.95; p = 0.02), but lower need for reintervention (RR 0.12, CI 0.02–0.91; p = 0.04). There were no differences in total (RR 0.88, CI 0.74–1.05; p = 0.15) or CV (RR 1.58, CI 0.87–2.86; p = 0.13) mortality, or stroke (RR 0.95, CI 0.68–1.32; p = 0.75) during follow-up. In conclusion, patients with DM had higher rates of AMI and lower need for reintervention after elective EVAR than those without DM, whereas neither total nor CV mortality differed between groups. The putative protective effects of DM towards further AAA enlargement and late sac rupture may help explain the lower need for reintervention and absence of excess mortality.

show abstract

The Protective Effects of Diabetes Mellitus on Post-EVAR AAA Growth and Reinterventions

Cited by 21 publications

References 32 publications

Diabetes and aortic aneurysm: current state of the art

Diabetes and aortic aneurysm: current state of the art

Long-term freedom from aneurysm-related mortality remains favorable after endovascular abdominal aortic aneurysm repair in a 15-year multicenter registry

Survival, cardiovascular morbidity, and reinterventions after elective endovascular aortic aneurysm repair in patients with and without diabetes: A nationwide propensity-adjusted analysis

Contact Info

Product

Resources

About