A literature review on pharmacologic therapy for abdominal aortic aneurysms
DOI:
https://doi.org/10.48750/acv.501Palavras-chave:
aneurysm, aorta, pharmacology, therapyResumo
Aortic aneurysms affect 3.3% of adults and there is a growing burden of small aneurysms detected, which may grow to need surgical repair. Still, we rely only on surgical therapy for this disease, left to monitor patients until they are candidates for treatment. Pharmacologic therapies have long been proposed and studied and still we have no evidence supporting drug therapy in small aneurysms. In this report we make a narrative review of basic molecular aspects of aneurysm disease and of evidence behind drug therapies that have been proposed and studied throughout the last decades.
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Referências
Ruddy JM, Jones JA, Spinale FG, Ikonomidis JS. Regional hetero-geneity within the aorta: relevance to aneurysm disease. J Thorac Cardiovasc Surg 2008;136:1123–30
Belardi P, et al. Type I aneurysmosis: complementary index for diagnosis. Vascular. 2005;13:11–5
Grondal N, Søgaard R, Lindholt JS. Baseline Prevalence of abdominal aortic aneurysm, peripheral arterial disease and hypertension in men aged 65-74 years from a population screening study (VIVA trial). BJS 2015;102:902-6
Castro-Ferreira R. Barreira R, Mendes P, Couto P, Peixoto F, Aguiar M, et al. First Population-Based Screening of Abdominal Aortic Aneurysm in Portugal. Ann Vasc Surg 2019;49,48-53
Chaikof EL, Brewster DC, Dalman RL, Makaroun MS, Illig KA, Sicard GA, et al. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. J Vasc Surg 201867:2-77.e2
Liu, B., Granville, D. J., Golledge, J. & Kassiri, Z. Pathogenic mechanisms and the potential of drug therapies for aortic aneurysm. Am J Physiol-heart 2020;318,H652-70
Blanchard JF, Armenian HK, Friesen PP. Risk factors for abdominal aortic aneurysm: results of a case-control study. Am J Epidemiol 2000;151:575–83.
Comuz J, Sidoti Pinto C, Tevaearai H, Egger M. Risk factors for asymptomatic abdominal aortic aneurysm: systematic review and meta-analysis of population- based screening studies. Eur J Public Health. 2004;14:343–9
Simpson CF, Boucek RJ, Noble NL. Influence of d-, l-, and dl-pro-pranolol, and practolol on B-aminopropionitile-induced aortic rup-tures of turkeys. Toxicol Appl Pharmacol 1976;38:169-75
Brophy CM, Tilson JE, Tilson D. Propranolol stimulates the crosslinking of matrix components in skin from the aneurysm-prone blotchy mouse. J Surg Res 1989; 46:330-2.
Slaiby JM, Ricci MA, Gadowski GR, Hendley ED, Pilcher DB.Propranolol reduces the size of aortic aneurysms in hypertensive rats. Surg Forum 1993;154:343-4.
Lindholt JS, Henneberg EW, Juul S, Fasting H. Impaired results of a randomised double blinded clinical trial of propranolol versus placebo on the expansion rate of small abdominal aortic aneurysms. Int Angiol.1999;18:52–7.
Propranolol Aneurysm Trial Investigators. Propranolol for small abdominal aortic aneurysms: results of a randomized trial. J Vasc Surg. 2002; 35:72–9.
Lindholt JS, Vammen S, Juul S, Henneberg EW, Fasting H. The validity of ultrasonographic scanning as screening method for abdominal aortic aneurysm. Eur J Vasc Endovasc Surg. 1999;17:472–5.
Propranolol for small abdominal aortic aneurysms: results of a randomized trial. J Vasc Surg. 2002;35:72–9.
Liao S, Miralles M, Kelley BJ, Curci JA, Borhani M, Thompson RW. Suppression of experimental abdominal aortic aneurysms in the rat by treatment with angiotensin-converting enzyme inhibitors. J Vasc Surg. 2001;3 3:1057–64.
Xiong F, Zhao J, Zeng G, Huang B, Yuan D, Yang Y. Inhibition of AAA in a rat model by treatment with ACEI perindopril. J Surg Res. 2014;189:166–173.
Sweeting MJ, Thompson SG, Brown LC, Greenhalgh RM, Powell JT. Use of angiotensin converting enzyme inhibitors is associated with increased growth rate of abdominal aortic aneurysms. J Vasc Surg.2010; 52:1–4.
Bicknell CD, Kiru G, Falaschetti E, Powell JT, Poulter NR; AARDVARK Collaborators. An evaluation of the effect of an angiotensin-converting enzyme inhibitor on the growth rate of small abdominal aortic aneurysms: a randomized placebo-controlled trial (AARDVARK). Eur Heart J. 2016;3 7:3213–21.
Lindeman JH & Matsumura JS. Pharmacologic Management of Aneurysms. Circ Res 2019; 124,631–46
Salata K, Sayed M, Hussain MA, de Mestral C, Greco E, Mamdani M, et al. Statins Reduce Abdominal Aortic Aneurysm Growth, Rupture, and Perioperative Mortality: A Systematic Review and Meta-Analysis. J Am Hear Assoc Cardiovasc Cerebrovasc Dis 7,2018; e008657
Lindholt JS, Sorensen HT, Michel JB, Thomsen HF, Henneberg EW. Low- dose aspirin may prevent growth and later surgical repair of medium-sized abdominal aortic aneurysms. Vasc Endovascular Surg. 2008;42:329–34.
Mortality results for randomised controlled trial of early elective surgery or ultrasonographic surveillance for small abdominal aortic aneurysms. The UK Small Aneurysm Trial Participants. Lancet. 1998;353:1649–55.
Bhak RH, Wininger M, Johnson GR, Lederle FA, Messina LM, Ballard DJ, Wilson SE; Aneurysm Detection and Management (ADAM) Study Group. Factors associated with small abdominal aortic aneurysm expansion rate. JAMA Surg. 201;150:44–50.
Franklin IJ, Walton LJ, Brown L, Greenhalgh RN, Powell JT. Vascular surgical society of great britain and ireland: non-steroidal anti-inflammatory drugs to treat abdominal aortic aneurysm.Br J Surg. 1999;86:707.
Patel K, Zafar MA, Ziganshin BA, Elefteriades JA. Diabetes mellitus: is it protective against aneurysm? A narrative review. Cardiology. 2018; 141:107–122.
FujimuraN,XiongJ,KettlerEB,XuanH,GloverKJ,MellMW,XuB,Dalman RL. Metformin treatment status and abdominal aortic aneurysm disease progression. J Vasc Surg. 2016;64:46-54e8
Yu X, Jiang D, Wang J, Wang R, Chen T, Wang K, et al. Metformin prescription and aortic aneurysm: systematic review and meta-analysis. Heart 2019;105:1351-7
Manning MW, Cassis LA, Daugherty A. Differential effects of doxycycline, a broad-spectrum matrix metalloproteinase inhibitor, on angiotensin II-induced atherosclerosis and abdominal aortic aneurysms. Arterioscler Thromb Vasc Biol. 2003;23:483–8.
Pyo R, Lee JK, Shipley JM, Cruci JA, Ziporin SJ, Ennis TL, et al. Targeted gene disruption of matrix metalloproteinase-9 (gelatinase B) suppresses development of experimental abdominal aortic aneurysms. J Clin Invest. 2000;105:1641–9.
Bartoli MA, Parodi FE, Chu J, Pagano MB, Mao D, Baxter BT, et al. Localized administration of doxycycline suppresses aortic dilatation in an experimental mouse model of abdominal aortic aneurysm. Ann Vasc Surg.2006;20:228–36.
Lindeman JH. The pathophysiologic basis of abdominal aortic aneurysm progression: a critical appraisal. Expert Rev Cardiovasc Ther. 2015;13:839–51.
Curci JA, Mao D, Bohner DG, Allen BT, Rubin BG, Reilly JM, et al. Preoperative treatment with doxycycline reduces aortic wall expression and activation of matrix metalloproteinases in patients with abdominal aortic aneurysms. J Vasc Surg. 2000; 31:325–42.
Mosorin M, Juvonen J, Biancari F, Satta J, Surcel HM, Leinonen M, et al. Use of doxycycline to decrease the growth rate of abdominal aortic aneurysms: a randomized, double-blind, placebo-controlled pilot study. J Vasc Surg. 2001;34: 606-10.
Meijer CA, Stignen T, Wasser MN, Hamming JF, van Bockel JH, Lindeman JH; Pharmaceutical Aneurysm Stabilisation Trial Study Group. Doxycycline for stabilization of abdominal aortic aneurysms. A randomized trial. Ann Intern Med. 2013;159:815-23.
Baxter BT, Matsumura J, Curci JA, McBride R, Larson L, Blackwelder W, et al. Effect of Doxycycline on Aneurysm Growth Among Patients With Small Infrarenal Abdominal Aortic Aneurysms/ A Randomized Clinical Trial. JAMA. 2020;323:2029-38
Gouveia e Melo R, Rodrigues M, Caldeira D, Alves M, Fernandes e Fernandes R, et al. Doxycycline is not Effective in Reducing Abdominal AorticAneurysm Growth: A Mini Systematic Review and Meta-Analysis of Randomised Controlled Trials. Eur J Vasc Endovasc Surg 2021;61,863-4