Cargando…
Systematic Review and Meta‐Analysis of Peak Wall Stress and Peak Wall Rupture Index in Ruptured and Asymptomatic Intact Abdominal Aortic Aneurysms
BACKGROUND: Prior studies have suggested aortic peak wall stress (PWS) and peak wall rupture index (PWRI) can estimate the rupture risk of an abdominal aortic aneurysm (AAA), but whether these measurements have independent predictive ability over assessing AAA diameter alone is unclear. The aim of t...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8174183/ https://www.ncbi.nlm.nih.gov/pubmed/33855866 http://dx.doi.org/10.1161/JAHA.120.019772 |
_version_ | 1783702852214980608 |
---|---|
author | Singh, Tejas P. Moxon, Joseph V. Gasser, T. Christian Golledge, Jonathan |
author_facet | Singh, Tejas P. Moxon, Joseph V. Gasser, T. Christian Golledge, Jonathan |
author_sort | Singh, Tejas P. |
collection | PubMed |
description | BACKGROUND: Prior studies have suggested aortic peak wall stress (PWS) and peak wall rupture index (PWRI) can estimate the rupture risk of an abdominal aortic aneurysm (AAA), but whether these measurements have independent predictive ability over assessing AAA diameter alone is unclear. The aim of this systematic review was to compare PWS and PWRI in participants with ruptured and asymptomatic intact AAAs of similar diameter. METHODS AND RESULTS: Web of Science, Scopus, Medline, and The Cochrane Library were systematically searched to identify studies assessing PWS and PWRI in ruptured and asymptomatic intact AAAs of similar diameter. Random‐effects meta‐analyses were performed using inverse variance‐weighted methods. Leave‐one‐out sensitivity analyses were conducted to assess the robustness of findings. Risk of bias was assessed using a modification of the Newcastle‐Ottawa scale and standard quality assessment criteria for evaluating primary research papers. Seven case‐control studies involving 309 participants were included. Meta‐analyses suggested that PWRI (standardized mean difference, 0.42; 95% CI, 0.14–0.70; P=0.004) but not PWS (standardized mean difference, 0.13; 95% CI, −0.18 to 0.44; P=0.418) was greater in ruptured than intact AAAs. Sensitivity analyses suggested that the findings were not dependent on the inclusion of any single study. The included studies were assessed to have a medium to high risk of bias. CONCLUSIONS: Based on limited evidence, this study suggested that PWRI, but not PWS, is greater in ruptured than asymptomatic intact AAAs of similar maximum aortic diameter. |
format | Online Article Text |
id | pubmed-8174183 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-81741832021-06-11 Systematic Review and Meta‐Analysis of Peak Wall Stress and Peak Wall Rupture Index in Ruptured and Asymptomatic Intact Abdominal Aortic Aneurysms Singh, Tejas P. Moxon, Joseph V. Gasser, T. Christian Golledge, Jonathan J Am Heart Assoc Systematic Review and Meta‐analysis BACKGROUND: Prior studies have suggested aortic peak wall stress (PWS) and peak wall rupture index (PWRI) can estimate the rupture risk of an abdominal aortic aneurysm (AAA), but whether these measurements have independent predictive ability over assessing AAA diameter alone is unclear. The aim of this systematic review was to compare PWS and PWRI in participants with ruptured and asymptomatic intact AAAs of similar diameter. METHODS AND RESULTS: Web of Science, Scopus, Medline, and The Cochrane Library were systematically searched to identify studies assessing PWS and PWRI in ruptured and asymptomatic intact AAAs of similar diameter. Random‐effects meta‐analyses were performed using inverse variance‐weighted methods. Leave‐one‐out sensitivity analyses were conducted to assess the robustness of findings. Risk of bias was assessed using a modification of the Newcastle‐Ottawa scale and standard quality assessment criteria for evaluating primary research papers. Seven case‐control studies involving 309 participants were included. Meta‐analyses suggested that PWRI (standardized mean difference, 0.42; 95% CI, 0.14–0.70; P=0.004) but not PWS (standardized mean difference, 0.13; 95% CI, −0.18 to 0.44; P=0.418) was greater in ruptured than intact AAAs. Sensitivity analyses suggested that the findings were not dependent on the inclusion of any single study. The included studies were assessed to have a medium to high risk of bias. CONCLUSIONS: Based on limited evidence, this study suggested that PWRI, but not PWS, is greater in ruptured than asymptomatic intact AAAs of similar maximum aortic diameter. John Wiley and Sons Inc. 2021-04-15 /pmc/articles/PMC8174183/ /pubmed/33855866 http://dx.doi.org/10.1161/JAHA.120.019772 Text en © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Systematic Review and Meta‐analysis Singh, Tejas P. Moxon, Joseph V. Gasser, T. Christian Golledge, Jonathan Systematic Review and Meta‐Analysis of Peak Wall Stress and Peak Wall Rupture Index in Ruptured and Asymptomatic Intact Abdominal Aortic Aneurysms |
title | Systematic Review and Meta‐Analysis of Peak Wall Stress and Peak Wall Rupture Index in Ruptured and Asymptomatic Intact Abdominal Aortic Aneurysms |
title_full | Systematic Review and Meta‐Analysis of Peak Wall Stress and Peak Wall Rupture Index in Ruptured and Asymptomatic Intact Abdominal Aortic Aneurysms |
title_fullStr | Systematic Review and Meta‐Analysis of Peak Wall Stress and Peak Wall Rupture Index in Ruptured and Asymptomatic Intact Abdominal Aortic Aneurysms |
title_full_unstemmed | Systematic Review and Meta‐Analysis of Peak Wall Stress and Peak Wall Rupture Index in Ruptured and Asymptomatic Intact Abdominal Aortic Aneurysms |
title_short | Systematic Review and Meta‐Analysis of Peak Wall Stress and Peak Wall Rupture Index in Ruptured and Asymptomatic Intact Abdominal Aortic Aneurysms |
title_sort | systematic review and meta‐analysis of peak wall stress and peak wall rupture index in ruptured and asymptomatic intact abdominal aortic aneurysms |
topic | Systematic Review and Meta‐analysis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8174183/ https://www.ncbi.nlm.nih.gov/pubmed/33855866 http://dx.doi.org/10.1161/JAHA.120.019772 |
work_keys_str_mv | AT singhtejasp systematicreviewandmetaanalysisofpeakwallstressandpeakwallruptureindexinrupturedandasymptomaticintactabdominalaorticaneurysms AT moxonjosephv systematicreviewandmetaanalysisofpeakwallstressandpeakwallruptureindexinrupturedandasymptomaticintactabdominalaorticaneurysms AT gassertchristian systematicreviewandmetaanalysisofpeakwallstressandpeakwallruptureindexinrupturedandasymptomaticintactabdominalaorticaneurysms AT golledgejonathan systematicreviewandmetaanalysisofpeakwallstressandpeakwallruptureindexinrupturedandasymptomaticintactabdominalaorticaneurysms |