Smoking, lung function and the prognosis of abdominal aortic aneurysm. The UK Small Aneurysm Trial Participants

TL;DRAbstract

BACKGROUND: the UK Small Aneurysm Trial was established to test the benefit of prophylactic elective surgery for small abdominal aortic aneurysms (4.0-5.5 cm in diameter) and identify prognostic risk factors, including smoking. PATIENTS, METHODS AND OUTCOMES: one thousand and ninety patients (902 men and 188 women, mean age 69.3 years) were randomised to either early elective surgery or ultrasonography surveillance until the aneurysm diameter exceeded 5. 5 cm, mean follow-up was 4.6 years. Baseline assessments included lung function tests and cotinine (a smoking marker). The principal outcome measures were all-cause mortality and aneurysm rupture. RESULTS: during the course of the trial, aneurysm rupture was diagnosed in 25 patients and 309 patients died. Whereas self-reported smoking status was not significantly associated with survival, patients without any trace of plasma cotinine had a significantly improved long-term (6-year) survival, p=0.02. Current smokers had a lower FEV(1)tha

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