Long-Term Clinical Outcomes of the Abdominal Aortic Aneurysm Get Fit Trial: A Randomised Controlled Trial of Exercise to Improve Fitness in Patients with Abdominal Aortic Aneurysm

Abstract Aim Improved fitness of patients on Abdominal Aortic Aneurysm (AAA) surveillance is predicted to reduce cardiovascular events and improve perioperative morbidity and mortality. The AAA GetFit Trial was a randomised control trial comparing community exercise programme (CEP) with standard care which demonstrated improved CardioPulmonary Exercise Test-related fitness in AAA patients to inform a definitive RCT. This study aims to investigate longer-term four-year clinical outcomes of these individuals. Method The AAA GetFit trial recruited participants from Greater Manchester's AAA Surveillance programme, and randomly assigned participants to either i)24-week CEP with choice of gym or home exercises, or ii) standard clinical care. We performed a retrospective analysis of prospective clinical outcomes from this trial over four-year follow-up reviewing whether they underwent operative repair, 30-day postoperative morbidity, cardiovascular event, and mortality with four-year followup. We defined 30-day post-operative morbidity using Clavien-Dindo classification≥3. Results In total,56 participants recruited, 28 were randomised to CEP group, 86% were males. Mean age at time of enrolment was 72.8(SD5.7) years. At four-year follow-up, mortality in CEP and control were both 14%(n = 4). In each group, 25%(n = 7) underwent operative repair. There was no perioperative mortality.Perioperative morbidity(n = 2) was 29% in CEP and 0% in control.Cardiovascular events(n = 9) was 7% in CEP and 25% in control.Mean diameter of aneurysm increased slower in CEPvsControl(0.84vs0.93cm). Conclusions The AAA GetFit trial showed significant benefits in cardiovascular fitness through community-based exercise. Although clinical outcomes thus far were similar in both groups, there is a suggestion of reduced cardiovascular events in the CEP group.