Abstract 15566: The Impact of Aspirin Use on Progression and Mortality of Abdominal Aortic Aneurysm

Abstract

Introduction: Preclinical studies demonstrated a potential role for aspirin (ASA) to slow the progression of abdominal aortic aneurysms (AAA) to rupture. We aim to investigate the association of long-term ASA use with progression and mortality in AAA. Methods: We queried the vascular ultrasound database at Cleveland Clinic for patients who underwent consecutive abdominal vascular ultrasound 2010-2020 if at least two available ultrasounds were conducted, without prior history of aneurysm repair, dissection, or rupture. ASA use was defined as at least one prescription of ASA during the during the follow-up period. The primary outcome was all-cause mortality, assessed by survival analysis with multivariable-adjust Cox regression. The secondary outcome was the mean annualized change of aneurysm diameter, assessed by multivariable-adjusted linear regression. Results: A total of 3,803 patients were included, with an average age of 73, and of which 826 (22%) were female and 2,380 (62.5%) were prescribed ASA (median duration of use ~ 9 years). ASA use was not significantly associated with all-cause mortality irrespective of age, sex and smoking status, except among those with a baseline diameter > 3.5 cm (Figure 1). ASA use was negatively associated with the mean annualized AAA diameter change only in males (0.25 vs 0.38 cm/year, p = 0.002) and in nonsmokers (0.26 vs 0.37 cm/year, p = 0.003). Conclusions: ASA use reduces the expansion of abdominal aortic aneurysms with altering all-cause mortality except in certain high-risk individuals in men and non-smokers. Mechanistic and randomized studies are needed to ascertain the role of ASA in patients with abdominal aortic aneurysms.