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Factors That Influence Growth Rates Of Abdominal Aortic Aneurysms: Analysis Of A Mexican Cohort
Luis O. Bobadilla-Rosado, MD1, Javier E. Anaya-Ayala, MD, MSc1, Eros Santos-Chavez, MD1, Manuel Garcia-Toca, MD2, Ignacio Martinez-Quezada, MD1, Ezequiel Solano-Mendivil, MD1, Hugo Laparra-Escareno, MD, MSc, PhD1, Nina Mendez-Dominguez, MD, MSc, DHSc3, Carlos A. Hinojosa, MD, MSc1.
1Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico, 2Emory University School of Medicine, Atlanta, GA, USA, 3Hospital Regional de Alta Especialidad de la Peninsula de Yucatan, Merida, Mexico.

Objective. Abdominal Aortic Aneurysms (AAA) growth rates and the most important factors that influence in pathogenesis of this complex process in Latin America population remain not fully understood. The objective of this study is to analyze changes in AAA diameter in a tertiary care facility in Mexico City. Methods. An observational, retrospective, study in which we analyzed the total of patients with AAA in which Computed Tomography studies were performed from 2014 to 2021. We then selected those who had a follow-up Computed Tomography; at least a year apart and divided them by groups (diabetic vs. non-diabetic and metformin Vs. no-metformin intake). We compared pre and post follow-up AAA diameters using paired t-tests. Categorical data were presented as frequencies and non-categorical data were presented as means and medians. Statistical analysis was performed on Stata 17. Results. A total 181 patients were found with AAA; out of the latter, 72 (39.77%) patients had a follow-up CT. Mean age was 75 years (9.05) and 52 (72.22%) were men. Regarding diabetes mellitus type 2, 23 (13.7%) were diabetic and 21 (12.5%) patients reported metformin intake. When analyzing infra-renal AAA diameters in our sample, median largest diameter was 39.8 mm (IQR 33.6-55.57 mm) whilst median largest diameter was 41.2 mm (IQR 34.4-51.02 mm) in the follow up scan.When comparing pre and post follow up AAA diameters in the non-diabetic group, mean largest diameter was 42.13 ( 12.55) vs. 45.33 8 14.83 (p = 0.02). In the diabetic group, mean infra-renal diameter was 35.12 mm (35.24) whilst mean follow up diameter was 36.32 (5.93) (p=0.01). When comparing infra-renal largest diameter through time based on metformin intake, a significant difference was found only in the metformin non-intake group (42.05 12.54 vs.45.34 12.06 [p=0.02]), in contrast the metformin intake group measures were non-significantly different (36.13 7.04 vs. 37.00 4.51; p = 0.57) through follow-up.
Conclusions. AAA diameters appear to change through time in a non-linear pattern influenced by different epidemiological and clinical factors. Metformin intake appears to promote a stability in AAA diameter growth.
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