Aspirin and Abdominal Aortic Aneurysms

The preclinical research indicates that aspirin may play a role in slowing the progression of abdominal aortic aneurysms (AAAs) and averting their rupture. However, human studies are scarce to demonstrate the clinical advantages of aspirin in treating AAA.

In a recent retrospective study of a clinical cohort of 3435 patients with objectively measured changes in aortic aneurysm progression, aspirin usage slowed the progression of abdominal aortic aneurysm (AAA) with a favorable safety profile.

This original Investigation on Cardiology was published in JAMA Network Open.

This retrospective study included adult patients with at least two vascular ultrasounds available at the Cleveland Clinic. Patients with a history of aneurysm repair, dissection, or rupture were excluded. All patients were followed for ten years, and clinical outcomes were analyzed from May 2022 to July 2023. The primary outcomes were the time-to-first occurrence of all-cause mortality, major bleeding, or a composite of dissection, rupture, and repair. Multivariable-adjusted Cox proportional-hazard regression and Fine and Gray proportional subhazard regression were used.

Key Summary Points

• There were 2672 male patients with a mean age of 73 years.
• The median follow-up duration was 4.9 years.
• Two thousand one hundred fifty patients were verified to be taking aspirin by prescription.
• Patients taking aspirin had a slower mean annualized change in aneurysm diameter (2.8 vs 3.8 mm per year) and lower odds of having rapid aneurysm progression compared to patients who were not taking aspirin.
• The adjusted odds ratio was 0.64.
• There was no association between aspirin use and risk of all-cause mortality, major bleeding, and composite outcome with aHR of 0.92, 0.88, and 1.16, respectively.

They said that in this study, aspirin use slowed the progression of abdominal aortic aneurysms, especially in men and nonsmokers. Aspirin use was not associated with all-cause mortality, major bleeding, or the risk of aneurysm dissection, rupture, or repair after ten years.

Reference

Hariri E, Matta M, Layoun H, et al. Antiplatelet Therapy, Abdominal Aortic Aneurysm Progression, and Clinical Outcomes. JAMA Netw Open. 2023;6(12):e2347296