Abstract
Aortic Wall Inflammation Predicts Abdominal Aortic Aneurysm Expansion, Rupture and Need for Surgical Repair
Highlights
Summary: This prospective, multicenter, open-label proof-of-concept phase II cohort study was conducted in Scotland
Ultrasmall superparamagnetic particles of iron oxide (USPIO)-enhanced magnetic resonance imaging is a novel approach to the identification of aortic wall cellular inflammation in patients with abdominal aortic aneurysms, and predicts the rate of aneurysm growth and clinical outcome
Patients with USPIO enhancement had higher rates of aneurysm rupture or repair (47.3% vs 35.6%; 95% confidence interval, 1.1%-22.2%; P 1⁄4 .0308), and this was similar for each component of rupture (6.8% vs 3.7%; P 1⁄4 .1857) or repair (41.8% vs 32.5%; P 1⁄4 .0782)
Summary
The findings of this study suggests a potential role for metformin in limiting abdominal aortic aneurysm (AAA) growth. The mean annual AAA growth rate was significantly slower (P 1⁄4 .012) in the 118 diabetic patients prescribed metformin (1.03 mm) but not in the 99 diabetic patients not prescribed metformin (1.60 mm) when compared with the 1140 nondiabetics patients not receiving metformin (1.62 mm). Mean annual AAA growth was significantly slower (P 1⁄4 .004) in the 39 diabetic patients prescribed metformin (1.40 mm), but not in the 30 diabetic patients not prescribed metformin (2.18 mm), than in the 218 nondiabetic patients not receiving metformin (2.55 mm). In cohort 3, the mean annual AAA growth was significantly slower (P 1⁄4 .018) in the 16 diabetic patients prescribed metformin (0.37 mm), but not in the 3 diabetic patients not prescribed metformin (0.95 mm), than in the 34 nondiabetic patients not receiving metformin (1.46 mm). No other diabetes treatment was associated with AAA growth in any cohort
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