(Circulation. 2000;102:e9047.)
© 2000 American Heart Association, Inc.
Cardiovascular News |
Cardiovascular News
Late-Breaking Trials at American Heart Association’s Scientific Sessions 2000
ADAM
Repairing patients’ small abdominal aortic aneurysms
surgically gives them no survival advantage over patients whose small
aneurysms are monitored by CT scan or ultrasound every 6 months, said
Frank A. Lederle, MD, who led the Department of Veterans Affairs (VA)
Aneurysm Detection and Management (ADAM) Study.
Dr Lederle of the VA Medical Center in Minneapolis, Minnesota said 1136 veterans aged 50 to 79 years were enrolled at 16 VA medical centers around the country. All the veterans had aneurysms from 4 to 5.4 cm in size. Of the study participants, 99% were male, 94% were white, and 42% had coronary artery disease. He presented the results at the late-breaking clinical trials session at the American Heart Association’s (AHA) Scientific Sessions 2000 in New Orleans from November 12 through 15, 2000.
The study was designed to answer the question as to whether the surgical repair of aneurysms <5.5 cm but >4 cm was better than frequent monitoring of the aneurysms by imaging techniques. The primary end point of the study was long-term survival.
Patients were randomized to surgical repair of the aneurysm
within 6 weeks of randomization or imaging surveillance using either CT
scan or ultrasound every 6 months. "Our screening studies had shown
that more than three-fourths of aneurysms over 4 cm were smaller than
5.5 cm and fell within the scope of our study," said Dr Lederle. A
smaller study in the United Kingdom had attempted to find the answer to
the same question and found no difference between