Beneficial effect of statins on total mortality in abdominal aortic aneurysm (AAA) repair

Abstract

In this single center, retrospective cohort study we wished to compare early and total mortality for all patients treated for abdominal aortic aneurysms (AAA) with open surgery who were taking statins compared to those who were not. A cohort of 640 patients with AAA was treated with open surgery between 1999 and 2012. Patients were consecutively recruited from a source population of 390,000; 21.3% were female, and the median age was 73 years. The median follow-up was 3.93 years, with an interquartile range of 1.79-6.58 years. The total follow-up was 2855 patient-years. An explanatory strategy was used. The propensity score (PS) was implemented to control for selection bias and confounders. The crude effect of statin use showed a 78% reduction of the 30-day mortality. A stratified analysis using the Mantel-Haenszel method on quintiles of the PS gave an adjusted effect of the odds ratio equal to 0.43 (95% CI: 0.18-0.96), indicating a 57% reduction of the 30-day mortality for statin users. The adjusted rate ratio was 0.62 (95% CI: 0.45-0.83), indicating a reduction of long-term mortality of 38% for statin users compared to non-users for a median follow-up of 3.93 years. This retrospective cohort study showed a significant beneficial effect of statin use on early and long-term survival for patients treated with open surgery. To be conclusive, our results need to be replicated by a randomized clinical trial.

Correlation between Sex and Prognosis of Acute Aortic Dissection in the Chinese Population

“…Some related reports pointed out that calcium-channel blockers are associated with reduced aortic expansion and improved survival in AAD. [ 18 19 ] Calcium antagonists generally blocked the slow calcium channels, decreasing the influx of extracellular calcium,[ 20 ] which resulted in suppression of the sinoatrial and atrioventricular nodes,[ 21 ] vascular dilation with decreased blood pressure, and reduced cardiac contractility. Adequate blood pressure regulation and subsequent decreased pressure on the aortic wall through calcium-channel blockade may theoretically decrease risks of aortic enlargement.…”

The influence of statins on aortic aneurysm after operation

“…Sven et al conducted a retrospective study in a single center to compare mortality for all AAA patients with open surgery and showed a significant beneficial effect of statin use on early and long-term survival. [13] Another study [14] also used ICD-9-CM codes to analyze the impact of preoperative statin use on the outcomes of Medicare patients who received either OPR or EVAR and showed mortality reduction at 90 days and 1 year. A systematic review and meta-analysis performed by Huang et al [8] also showed the benefit of statin therapy on survival after AAA.…”

Increased Risk of Peripheral Arterial Disease in Patients With Abdominal Aortic Aneurysm: A Retrospective Cohort Study (Version 5)

“…A recent retrospective cohort study reported that patients with AAA on statins treatment had a 38% reduction in long-term mortality after a medium follow-up of 3.93 years. 38 It is worthwhile for us to further evaluate the effectiveness of statin medication for AAA patients on the risk of developing AAA.…”