The Associations Between Diabetes and Metformin and Abdominal Aortic Aneurysm (AAA) Events: A Retrospective Cohort Study

The aim of this study was to determine, among persons 66 years age or older, the associations between no diabetes, diabetes and metformin, metformin abdominal aortic aneurysm (AAA) events. We conducted a retrospective cohort using universal coverage administrative health data housed within ICES (formerly Institute for Clinical Evaluative Sciences). Our included Ontario adults, aged identified 2000 2013, with 5-, 10-, 15-year follow-up January 1, 2020. primary outcome discharge diagnosis ruptured AAA whether repaired not, and/or procedural code repair, not. Metformin medications were in Drug Benefit (ODB) database, which covers all Ontarians >65. Using Cox time-dependent regression, we determined hazard ratios (HRs) 95% confidence intervals (CIs) different exposure groups at 5, 10, 15 while controlling priori covariates. analytical consisted 2,479,684 individuals: (82.5%; n = 2,046,209), (10.3%; 255,987), (7.1%; 177,541) entry (Table I); 21,464 (0.9%) had an event. In both diabetic groups, (HR CI) without CI), repairs (non-ruptured) decreased time points comparison non-diabetic group. This relative reduction more pronounced group decrease 47% follow-up. Diabetes not significantly associated risk rupture when compared 59% Diabetes, decreases non-ruptured repair. Only timepoints.Table 1Associations eventsGroup1 Year5 Years10 Years15 YearsEventsAdjusted HR (95% CI)EventsAdjusted CI)AAA No diabetes/no metformin2021 (ref)8691 (ref)14681 (ref)17651 (ref) metformin80.31 (0.15-0.62)570.48 (0.36-0.63)880.44 (0.35-0.54)950.41 (0.33-0.51) metformin261.07 (0.70-1.65)881 (0.80-1.25)1220.89 (0.74-1.08)1340.87 (0.73-1.05)AAA non-rupture diabetes/No metformin14921 (ref)74081 (ref)13,5641 (ref)16,9811 metformin1880.76 (0.65-0.88)7080.59 (0.54-0.63)11790.56 (0.52-0.59)13250.53 (0.50-0.56) metformin1480.82 (0.69-0.97)6180.78 (0.72-0.85)10190.80 (0.75-0.86)11600.79 (0.74-0.84)CI, Confidence interval; HR, ratio; ref, reference.All analyses controlled for: sex, patient age, socioeconomic status by neighborhood income quintile, comorbidity Johns Hopkins Aggregated Diagnosis Groups (ADGs). Open table new tab