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  • A new study finds that aspirin may help reduce the progression of an aneurysm.
  • Currently, managing risk factors — like smoking and blood pressure — is the best way to prevent abdominal aortic aneurysm.
  • Researchers say there is a need for more medications to help control aneurysms.

Aspirin may slow abdominal aortic aneurysm (AAA) progression, a new study has found.

While aspirin didn’t appear to impact the risk of rupture, major bleeding or death, the findings, published inJAMA Network Open Tuesday, suggest that aspirin could be used to delay AAA progression in certain patients.

Currently, managing risk factors — like smoking and blood pressure — is the best way to prevent AAA and there’s a need for medications to slow the growth of these types of aneurysms.

Blood pressure lowering medications and certain antibiotics do not appear to impact progression or the risk of rupture, past evidence suggests.

Aspirin is an anti-platelet medication and preclinical studies have shown that platelet activation plays a role in the development and progression of AAA.

Additionally animal models have found that anti-platelet drugs may prevent clot formation, however, it’s been unclear if they have this same effect in humans.

Research has also explored the use of anti-platelet drugs with other types of aneurysms, including intracranial aneurysms, but the evidence has been mixed.

“This is a critical area of clinical investigation, as no medical therapy has previously been shown to be effective in [preventing] disease progression,” said Dr. Ronald Dalman, a professor of vascular surgery at Stanford Medicine. Dalman was not involved in the study.

The report included a total of 3,435 people who had at least two vascular ultrasounds conducted at the Cleveland Clinic.

The patents were followed up with for 10 years.

The researchers tracked the following outcomes: death due to any cause, major bleeding episodes, and aneurysm dissection, rupture, or repair.

Of the group, 2,150, or 63%, took aspirin by prescription.

The researchers found that the progression of the aneurysm was significantly slower among those who took aspirin.

However, aspirin use was not associated with a risk of death due to any cause, a major bleeding episode, or aneurysm dissection, rupture, or repair.

This was a retrospective study, so only correlation, not causation, can be inferred, Dalman noted.

It’s worth noting that patients taking aspirin were also more likely to be taking other medications that could potentially impact AAA progression, such as metformin and statins, Dalman added.

Still, doctors say the findings suggest aspirin might be a useful treatment option for people with AAA.

“This was the first large-scale study to specifically examine the role of aspirin in patients with AAA and is the first study that shows a correlation between a medical therapy (aspirin) and decreased growth of AAA,” said Dr. Cheng-Han Chen, an interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA. Chen was not involved in the study.

Metformin, a drug that helps control blood sugar levels, is associated with slower aneurysm progression, however, it’s been difficult to find other medications that may slow AAA growth.

“Previous studies have tested many types of drug classes including beta-blockers and angiotensin-converting enzyme inhibitors, without showing any benefit,” says Chen.

The researchers suspect that, based on the findings, aspirin may help fill that gap.

According to Dalman, there are several potential mechanisms that can explain aspirin’s benefits.

For example, he says aspirin may reduce the size and accumulation of blood clots that can develop on the wall of the aneurysm as it gets bigger.

“It is possible that increased platelet activation along with increased inflammatory response within the aneurysm drives AAA growth, and that aspirin ameliorates this effect,” says Chen.

That said, because aspirin didn’t appear to prevent rupture or reduce the need for surgical repair, it’s unclear how useful the drug may be, says Dalman.

Dalman hopes the results inspire future studies to explore the effects of aspirin along with other anti-platelet therapies in AAA disease management.

“Having cross-sectional imaging studies available to evaluate the effect of aspirin therapy on thrombus accumulation and the relationship between thrombus volume and AAA diameter change, would be the next, most important questions to consider,” he said.

A new report found that aspirin may slow abdominal aortic aneurysm (AAA) progression. Scientists have struggled to find medications that can slow the growth of these types of aneurysms. Future studies will need to explore the effects of aspirin on AAA development.