Document Detail


Does EVAR alter the rate of cardiovascular events in patients with abdominal aortic aneurysm considered unfit for open repair? Results from the randomised EVAR trial 2.
MedLine Citation:
PMID:  20096611     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To investigate whether endovascular aneurysm repair (EVAR) influences the rate of cardiovascular events (fatal or non-fatal myocardial infarction or stroke) in patients with abdominal aortic aneurysm (AAA) considered unfit for open repair.
DESIGN: Randomised controlled trial.
MATERIALS: Between 1999 and 2004, 404 patients with large AAA considered unfit for open repair were randomised to EVAR or no surgical intervention across 33 UK hospitals and followed until July 2009.
METHODS: The Customised Probability Index was used to determine fitness for each patient and Cox regression was used to compare time to first cardiovascular event between randomised groups and levels of fitness.
RESULTS: During an average of 2.8 years of follow-up, 67 first cardiovascular events occurred with a non-significantly higher event rate in the EVAR group compared to the no intervention group (6.6 versus 5.1 events per 100 person years); adjusted hazard ratio 1.42 [95% CI 0.87-2.34], p=0.156. There was no evidence to suggest that the hazard ratio between randomised groups changed with level of fitness (p=0.378).
CONCLUSIONS: Cardiovascular event rates were high in these unfit patients and medical therapy was sub-optimal. Events rates were slightly higher in the EVAR group but this was not statistically significant.
Authors:
L C Brown; R M Greenhalgh; S G Thompson; J T Powell;
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-01-21
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  39     ISSN:  1532-2165     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-05     Completed Date:  2010-04-15     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  396-402     Citation Subset:  IM    
Data Bank Information
Bank Name/Acc. No.:
ISRCTN/ISRCTN55703451
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal / mortality,  radiography,  surgery*
Aortography / methods
Blood Vessel Prosthesis Implantation / adverse effects*,  mortality
Chi-Square Distribution
Female
Great Britain
Humans
Kaplan-Meier Estimate
Male
Myocardial Infarction / etiology*,  mortality
Patient Selection
Proportional Hazards Models
Risk Assessment
Risk Factors
Severity of Illness Index
Stroke / etiology*,  mortality
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Grant Support
ID/Acronym/Agency:
MC_U105260792//Medical Research Council; //Department of Health

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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