The TABS Study: Analysis of Determinants of AAA Diameter and Growth Rate in Individuals of the Spanish Population

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Background: The risk of Abdominal Aortic Aneurysms (AAA) rupture is associated with aneurysm size and growth rate. There is substantial variation in growth rates between individuals. The present study aims to provide a global description of growth rates per intervals of AAA diameter size for individuals in the Spanish population, to understand possible causes of growth rate variability, and to assess practitioners on safe follow-up visits for AAA patients. Methods: We present the Triple-A Barcelona Study (TABS), a new hospital-based study recruiting individuals with AAA in Barcelona. So far, 1371 measurements of the abdominal aortic diameter from 274 individuals have been registered by CT-scan or by ultrasound. Anthropometric and clinical information, plasma, DNA and RNA samples have been collected for most follow-up visits. Aortic diameter growth was calculated by linear regression of all measures for each individual. Statistical modeling of aortic diameter (mm) or aortic diameter growth rate (mm/year) was performed to identify the most relevant predictors of diameter size and expansion in individuals with AAA using linear mixed-effect models. Results and Discussion: The average growth rate calculated for all intervals was 2.86 mm/year, with a significant increase in growth rates for increasing diameter at baseline intervals, as expected ([ Table 1 ]). The best model to predict aortic diameter included age, height, BMI, hypertension, dyslipidemia, and kidney disease, indicating that these variables are important determinants of aortic diameter in individuals with AAA and provide a more accurate prediction of AAA diameter. In line with previous works, the estimated time to reach an aneurysm size of 55 mm in males or 50 mm in females (surgical threshold) for individuals with small aneurysms exceeded the currently used surveillance times in Spain ([ Figure 1 ]), indicating that the current follow-up visits could be reduced for small aneurysms in both sex. Table 1 Variable [30,45] (n=648) (45,55] (n=602) (55,100] (n=150) (n=1400) Mean growth rate (SD), n 1.19 (2.25), 137 2.57 (3.10), 147 4.62 (5.80), 41 Fig. 1 Publication History Article published online: 11 June 2024 © 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/) Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

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