The quality of evidence is downgraded by study limitations (unclear allocation concealment), by indirectness (differences between the outcomes of interest and those reported: only short-term outcomes reported), and by imprecise results (few patients and outcome events).
A Cochrane review [Abstract] 1 included 1 study with 227 subjects with abdominal aortic aneurysm (AAA). The included study measured the effects of metoprolol on the incidence of cardiac complications at 30 days and 6 months after vascular surgery; a subgroup of 227 patients had an abdominal aortic repair.
There was no clear evidence that metoprolol compared to placebo reduced all-cause mortality (OR 0.17, 95% CI 0.02 to 1.41), cardiovascular death (OR 0.20, 95% CI 0.02 to 1.76), AAA-related death (OR 1.05, 95% CI 0.06 to 16.92) or increased nonfatal cardiovascular events (OR 1.44, 95% CI 0.58 to 3.57) 30 days postoperatively. At 6 months postoperatively, estimated effects were compatible with benefit and harm for all-cause mortality (OR 0.71, 95% CI 0.26 to 1.95), cardiovascular death (OR 0.73, 95% CI 0.23 to 2.39) and nonfatal cardiovascular events (OR 1.41, 95% CI 0.59 to 3.35). Adverse drug effects were reported for the whole study population and were not available for the subgroup of participants with AAA.
The aim of the review was to determine the long-term effectiveness of antiplatelet, antihypertensive or lipid-lowering medication in reducing mortality and cardiovascular events in people with AAA. No studies on antiplatelet or lipid-lowering medication were found.
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