Aortic aneurysm diameter and risk of cardiovascular mortality

After successful surgical repair of an abdominal aortic aneurysm, patients have for many years an increased risk of death from cardiovascular causes. We have tested the hypothesis that for patients with abdominal aortic aneur ysms, the risk of nonaneurysm cardiovascular mortality before and after sur gery increased with aneurysm diameter. Records of aneurysm repair or ruptur e and mortality were available from 2305 patients entered into the UK Small Aneurysm Trial and Study. Two hundred fifty-nine deaths occurred before an eurysm repair or rupture (mean follow-up 1.7 years), and 325 occurred after surgical repair (mean follow-up 3.6 years). The risk of nonaneurysm-relate d mortality and cardiovascular death before and after surgery increased wit h aneurysm diameter at baseline, even after adjustment for other known risk factors. The adjusted hazard ratios for cardiovascular mortality, per stan dard deviation (0.8-cm) increase in aneurysm diameter, were 1.34 (95% CI 1. 01 to 1.79) and 1.31 (95% CI 1.06 to 1.63) in the periods before aneurysm r epair or rupture and after aneurysm repair, respectively. The significant a ssociation between aortic diameter and cardiovascular mortality, excluding aneurysm-related deaths, suggests that aneurysm diameter is an independent marker of cardiovascular disease risk.