Abdominal aortic aneurysms do not develop more aggressively among patients with a positive family history of the disease

Title:
Abdominal aortic aneurysms no not develop more aggressively among patients with a positive family history of the disease

Authors:
Trine M. M. Joergensen, Holger Wemmelund, Anders Green, Jes Lindholt, Kim Houlind.

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 uncertain whether familial AAA’s develops differently than non-familial AAA’s.

Objectives:
To investigate whether familial AAA’s develop more aggressively than non-familial AAA’s by looking at 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:
318 patients (273 men and 45 women) with AAA diagnosed between 1996-2008 in Jutland, Denmark with information on family history of AAA, diameter of AAA throughout follow-up, surgery, ruptures, comorbidity, smoking, and use of medication.

Methods:
Patients with and without a family history of AAA were compared regarding mean age at diagnosis and surgery, 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 possible confounders.

Results:
Patients with a family history of AAA were 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 regarding age at operation (72.2 vs. 70.6, p=0.204) or regarding 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 (95%CI: 3.73;6.78) for patients with positive family history and 6.19 mm/year (95%CI: 4.40;7.97) for patients with no family history of AAA (p=0.490)).

Conclusions:
We found no evidence to suggest that abdominal aortic aneurysms develop more aggressively among patients with a positive family history of the disease.