Propranolol for small abdominal aortic aneurysms: Results of a randomized trial

Purpose: Animal and human studies have suggested that beta-blockade may decrease the growth rate of aneurysms. We investigated whether propranolol decreases the growth rate of small abdominal aortic aneurysms (AAAs). Methods: We randomly assigned patients with an asymptomatic AAA between 3.0 and 5.0...

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Published in:	Journal of vascular surgery Vol. 35; no. 1; pp. 72 - 79
Main Author:	The Propranolol Aneurysm Trial Investigators
Format:	Journal Article
Language:	English
Published:	New York, NY Elsevier Inc 01-01-2002 Elsevier
Subjects:	Adrenergic beta-Antagonists - therapeutic use Aged Aorta, Abdominal - diagnostic imaging Aorta, Abdominal - drug effects Aortic Aneurysm, Abdominal - diagnostic imaging Aortic Aneurysm, Abdominal - drug therapy Aortic Aneurysm, Abdominal - mortality Biological and medical sciences Cardiovascular system Double-Blind Method Female Follow-Up Studies Health Status Humans Male Medical sciences Pharmacology. Drug treatments Propranolol - therapeutic use Quality of Life Time Factors Treatment Outcome Ultrasonography Vascular wall Human Small dimension Prognosis Growth Aneurysm Cardiovascular disease Controlled therapeutic trial Arterial disease Vascular disease Abdominal aorta Chemotherapy Treatment Follow up study Propranolol Aortic disease Beta blocking agent
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Summary:	Purpose: Animal and human studies have suggested that beta-blockade may decrease the growth rate of aneurysms. We investigated whether propranolol decreases the growth rate of small abdominal aortic aneurysms (AAAs). Methods: We randomly assigned patients with an asymptomatic AAA between 3.0 and 5.0 cm to receive either a placebo (n = 272) or propranolol (n = 276) in a double-blind fashion. Patients were observed for a mean of 2.5 years. The primary end point was the mean annual growth rate as determined by means of ultrasound scanning performed every 6 months. Secondary outcomes were death, surgery, withdrawal from study medication, and quality of life measured by means of the Short-form Health Survey (SF-36). The main analyses were performed by means of intention to treat. Results: The two groups were similar at baseline: 84% were men with a mean age of 69 years and a mean AAA size of 3.8 cm. Fewer patients in the placebo group stopped their study medication (26.8% vs 42.4%; P =.0002). The annual growth rate was similar in the two groups (placebo, 0.26 cm/y vs propranolol 0.22 cm/y; P =.11). There was a trend toward more elective surgery in the placebo group (26.5% vs 20.3%; P =.11), but there was no difference in death rate (placebo, 9% vs propranolol, 12%; P =.36). Patients in the propranolol group had significantly poorer quality of life scores in the physical functioning, physical role, and vitality dimensions of the SF-36. Conclusion: Patients with AAAs do not tolerate propranolol well, and the drug did not significantly affect the growth rate of small AAAs. (J Vasc Surg 2002;35:72-9.)
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 ObjectType-News-3 content type line 23
ISSN:	0741-5214 1097-6809
DOI:	10.1067/mva.2002.121308