Temporal Trends in Medical Cardioprotective Treatment in Patients with Abdominal Aortic Aneurysms: A Population-Based National Cohort Study

Background and Aims : Patients with abdominal aortic aneurysmal (AAA) disease suffer high morbidity and mortality, driven mainly by cardiovascular comorbidity, and not the aneurysmatic disease itself. Initiation of cardioprotective therapy with statin and antiplatelets is recommended at AAA diagnosis. However, the implementation of recommendations over time is not well described. We aimed to provide up-to-date insights on temporal trends in the use of cardioprotective therapy in patients diagnosed with AAA.Methods: Through national population-based health registries, we identified patients with an incident diagnosis of AAA from 2000 through 2018. By means of descriptive statistics, we characterized the development in prescription claims of statin and antiplatelet therapy. Analyses were stratified on year of diagnosis in the following intervals: 1999–2003, 2004–2008, 2009-2013, and 2014–2018.Results: We identified 33,296 individuals with an incident diagnosis of AAA during 2000-2018. Mean age was 74 years. Prevalence of cardiovascular comorbidity (e.g., ischemic heart disease, cerebrovascular disease) ranged between 32.6% and 41.5%. The use of statins increased from 17.9% in 1999-2003 to 66.9% in 2014-2018, use of antiplatelets increased from 45.6% to 63.3%, and combined therapy with both statin and antiplatelets from 11.3% to 44.8%. Developments in medication use plateaued after 2013.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Background and Aims : Patients with abdominal aortic aneurysmal (AAA) disease suffer high morbidity and mortality, driven mainly by cardiovascular comorbidity, and not the aneurysmatic disease itself. Initiation of cardioprotective therapy with statin and antiplatelets is recommended at AAA diagnosis. However, the implementation of recommendations over time is not well described. We aimed to provide up-to-date insights on temporal trends in the use of cardioprotective therapy in patients diagnosed with AAA. Methods: Through national population-based health registries, we identified patients with an incident diagnosis of AAA from 2000 through 2018. By means of descriptive statistics, we characterized the development in prescription claims of statin and antiplatelet therapy. Analyses were stratified on year of diagnosis in the following intervals: 1999–2003, 2004–2008, 2009-2013, and 2014–2018. Results: We identified 33,296 individuals with an incident diagnosis of AAA during 2000-2018. Mean age was 74 years. Prevalence of cardiovascular comorbidity (e.g., ischemic heart disease, cerebrovascular disease) ranged between 32.6% and 41.5%. The use of statins increased from 17.9% in 1999-2003 to 66.9% in 2014-2018, use of antiplatelets increased from 45.6% to 63.3%, and combined therapy with both statin and antiplatelets from 11.3% to 44.8%. Developments in medication use plateaued after 2013.