Systematic review and meta-analysis of the effects of statin therapy on abdominal aortic aneurysms
- 24 November 2010
- journal article
- review article
- Published by Oxford University Press (OUP) in British Journal of Surgery
- Vol. 98 (3), 346-353
- https://doi.org/10.1002/bjs.7343
Abstract
Background: The aim was to investigate the effects of statin therapy on abdominal aortic aneurysm (AAA) disease. Methods: PubMed, the Cochrane Library, Embase and ClinicalTrials.gov were searched for all studies on any clinical effect of statin therapy on AAA. Outcomes were selected based on their inclusion in two or more studies: AAA expansion rate, 30‐day mortality, and short‐ and long‐term postoperative mortality. The data were subjected to meta‐analysis by outcome. Results: Twelve cohort studies were selected for inclusion involving 11 933 individuals. Meta‐analysis of four studies examining all‐cause postoperative mortality showed a significant improvement with statin therapy at 1, 2 and 5 years (odds ratio (OR) at 5 years 0·57, 95 per cent confidence interval (c.i.) 0·42 to 0·79; P < 0·001) with minimal heterogeneity between the four included studies. There was no significant difference in 30‐day mortality after AAA treatment in patients on statin therapy (OR 0·22, 0·02 to 2·90; P = 0·25). Sensitivity analysis including four high‐quality studies examining AAA expansion rates showed no significant difference with statin therapy: standardized mean difference −0·14 (95 per cent c.i. −0·33 to −0·05) mm/year (P = 0·16). Conclusion: The claim of a reduction in AAA expansion rate with statin therapy is based on low‐quality evidence and was not significant on meta‐analysis. However, statin therapy did appear to improve all‐cause survival after AAA repair. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.Keywords
This publication has 34 references indexed in Scilit:
- Association of statin prescription with small abdominal aortic aneurysm progressionAmerican Heart Journal, 2010
- Growth rates of small abdominal aortic aneurysms correlate with clinical eventsBritish Journal of Surgery, 2009
- Role of medical intervention in slowing the growth of small abdominal aortic aneurysmsPublished by Oxford University Press (OUP) ,2009
- The ACE trial: A randomized comparison of open versus endovascular repair in good risk patients with abdominal aortic aneurysmJournal of Vascular Surgery, 2009
- The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and ElaborationPLoS Medicine, 2009
- The use of statins and fate of small abdominal aortic aneurysmsInteractive CardioVascular and Thoracic Surgery, 2008
- The Efficacy of Pharmacotherapy for Decreasing the Expansion Rate of Abdominal Aortic Aneurysms: A Systematic Review and Meta-AnalysisPLOS ONE, 2008
- Effect of statins on proteolytic activity in the wall of abdominal aortic aneurysmsBritish Journal of Surgery, 2007
- Lipid-lowering for peripheral arterial disease of the lower limbCochrane Database of Systematic Reviews, 2007
- Mortality and Size of Abdominal Aortic Aneurysm at Long-Term Follow-Up of Patients Not Treated Surgically and Treated With and Without StatinsThe American Journal of Cardiology, 2006