Effect of Antiplatelet Agents on Abdominal Aortic Aneurysm Process: A Systematic Review and Meta-Analysis

Abstract

Background: This systematic review and meta-analysis aims to investigate whether antiplatelet agents are associated with the reduction, expansion, and rupture of abdominal aortic aneurysm (AAA). Methods: A thorough exploration was conducted on four prominent databases, namely EMBASE, Ovid, PubMed, and Scopus, to identify studies that reported the influence of antiplatelet agents on the sac development of AAA. The assessment was carried out until March 2023. R software v.4.1 was used for statistical analysis. Results: After reviewing 13 publications which included a total of 5392 patients (1446 in the antiplatelet group and 2540 in the control group), a meta-analysis was conducted. The results of the analysis revealed that there was no significant difference in the annual growth rate of AAA diameter between those who received antiplatelet agents and those who did not (mean difference (MD) = –0.04, 95% CI = [–0.37, 0.30]; heterogeneity: p < 0.01, I2 = 91%, τ2 = 0.1278). Additionally, there was no difference in the number of patients who experienced aneurysm diameter expansion between the two groups, significantly (odds ratio (OR) = 0.96, 95% CI = [0.41, 2.25]; heterogeneity: p < 0.01, I2 = 78%, τ2 = 0.5849). Conclusions: Antiplatelet agents do not affect AAA’s reduction, expansion, or rupture. There is no benefit to AAA patients taking antiplatelet agents for the purpose of slowing down growth rates of sac diameter.

Keywords

• abdominal aortic aneurysm
• antiplatelet agents
• aspirin
• endovascular aortic repair
• meta-analysis