600 Long-Term Clinical Outcomes of the Abdominal Aortic Aneurysm Get Fit Trial: A Randomised Controlled Trial of Exercise to Improve Fitness in Patients with Abdominal Aortic Aneurysm
T Tay, A Haque- Surgery
Abstract
Aim
Improved fitness of patients on Abdominal Aortic Aneurysm (AAA) surveillance is predicted to reduce cardiovascular events and improve perioperative morbidity and mortality. The AAA GetFit Trial was a randomised control trial comparing community exercise programme (CEP) with standard care which demonstrated improved CardioPulmonary Exercise Test-related fitness in AAA patients to inform a definitive RCT. This study aims to investigate longer-term four-year clinical outcomes of these individuals.
Method
The AAA GetFit trial recruited participants from Greater Manchester's AAA Surveillance programme, and randomly assigned participants to either i)24-week CEP with choice of gym or home exercises, or ii) standard clinical care. We performed a retrospective analysis of prospective clinical outcomes from this trial over four-year follow-up reviewing whether they underwent operative repair, 30-day postoperative morbidity, cardiovascular event, and mortality with four-year followup. We defined 30-day post-operative morbidity using Clavien-Dindo classification≥3.
Results
In total,56 participants recruited, 28 were randomised to CEP group, 86% were males. Mean age at time of enrolment was 72.8(SD5.7) years. At four-year follow-up, mortality in CEP and control were both 14%(n = 4). In each group, 25%(n = 7) underwent operative repair. There was no perioperative mortality.Perioperative morbidity(n = 2) was 29% in CEP and 0% in control.Cardiovascular events(n = 9) was 7% in CEP and 25% in control.Mean diameter of aneurysm increased slower in CEPvsControl(0.84vs0.93cm).
Conclusions
The AAA GetFit trial showed significant benefits in cardiovascular fitness through community-based exercise. Although clinical outcomes thus far were similar in both groups, there is a suggestion of reduced cardiovascular events in the CEP group.