Abstract :
Introduction: It is well known that a family history of Abdominal Aortic Aneurysm (AAA) strongly increases the risk of developing AAA, but it is still unknown whether familial AAAs develop differently than non-familial AAAs.
Objectives: To investigate whether familial AAAs develop more aggressively than non-familial AAAs by looking at the growth rate, risk of surgery and rupture, as well as the size of the aneurysm at the time of diagnosis and the patient’s age at the time of operation, rupture and diagnosis.
Design: Observational retrospective longitudinal study.
Materials and Methods: 318 patients with AAA diagnosed between 1996-2008 in Jutland, Denmark with information on family history of AAA, the diameter of AAA throughout follow-up, surgery, ruptures, comorbidity, smoking, and use of medication. Patients with and without a family history of AAA were compared regarding mean age at diagnosis and surgery, the diameter of AAA at diagnosis, risk of surgery and rupture as well as comorbidity and use of medication. Mean growth rates were compared between the two groups and a mixed-effects model was fitted to control for confounders.
Results: We included 93 patients with and 225 without a family history of AAA. Patients with a family history of AAA ere significantly younger than patients with no family history of the disease (69.8 vs. 72.4 years, p=0.032), but we found no significant differences in age at operation (72.2 vs. 70.6, p=0.204), the proportion of patients experiencing rupture (16.0 vs. 10.6%, p=0.226) or undergoing surgery (78.2% vs. 81.7%, p=0.484). We found no significant difference in growth rates between the two groups; 5.25 mm/year for patients with positive family history and 6.19 mm/year for patients with no family history of AAA (p=0.490).
Conclusions: We found no evidence to suggest that AAA develops more aggressively in patients with a positive family history of the disease.
Keyword :
Abdominal aortic aneurysm, Family history, Vascular surgery, AAA, Aortic diseases