Abstract 12222: The Role of Metformin in Abdominal Aortic Aneurysm: A Systematic Review and Meta-Analysis

Abstract

Introduction: Abdominal aortic aneurysm (AAA) is a cardiovascular disease with very high mortality especially due to its tendency to be asymptomatic. Some reports suggest that patients with diabetes, especially those who take metformin, may be negatively associated with AAA, but the association is still unclear. Hence, we aim to conduct a systematic review with meta-analysis on the role of metformin in reducing AAA diameter progression and AAA-related events. Hypothesis: We hypothesized that metformin reduces the growth of AAA diameter and AAA-related events. Methods: A comprehensive search of relevant articles was systematically performed on PubMed, Science Direct, Cochrane, and Scopus for studies comparing metformin with no metformin treatment on patients with AAA. Two reviewers independently assessed the abstracts and full-text articles. The outcome was aortic enlargement progression and AAA-related events such as AAA rupture and mortality. Biases in selected studies were assessed using Newcastle-Ottawa Scale. Data from eligible studies were pooled for effect estimates. Statistical analysis was performed using Review Manager software. Results: A total of 11 articles comprising 110,727 patients were included in the systematic review. Results showed that metformin was associated with reduction of annual AAA diameter progression (weighted mean difference: -0.84 mm; 95%CI: -1.33 to -0.35; p: 0.0007; I 2 : 85%). Metformin treatment may be associated with a decrease in AAA-related events. Funnel plot analysis showed that there was an indication of publication bias. Conclusions: Our results may suggest a potential role for metformin in limiting AAA growth. Further randomized controlled trials are needed to confirm the results.