Effects of statin therapy on ascending aorta aneurysms growth: A propensity-matched analysis

Angeloni, Emiliano; Vitaterna, Angelo; Pirelli, Michele; Refice, Simone

doi:10.1016/j.ijcard.2015.05.001

Cited by 40 publications

(28 citation statements)

References 18 publications

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“…Renal failure and female sex were identified as being associated with faster annual growth rate in 2 separate studies, 14,16 while anticoagulation and statin medication use were found be associated with a lower growth rate. 11,13 In addition, factors associated with increased risk of dissection and rupture were poorly reported. Coady et al 27 and Vapnik et al 15 demonstrated that size was the most important factor associated with acute dissection or rupture; however, most other studies did not report aneurysm size at aortic dissection or rupture, and comparison was therefore not possible.…”

Section: Discussionmentioning

confidence: 99%

Association of Mortality and Acute Aortic Events With Ascending Aortic Aneurysm

et al. 2018

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Key Points Question What are the growth rate and risk of complications in patients with moderately dilated ascending aortas? Findings This systematic review and meta-analysis of 20 studies including 8800 patients found that the ascending aorta growth rate was 0.61 mm/y, and the incidence of elective aortic surgery was 13.82%. The linearized mortality rate was 1.99% per patient-year, while the rate of aortic dissection, aortic rupture, and mortality was 2.16% per patient-year. Meaning More robust natural history data from prospective studies are needed to better inform clinical decision making in patients with ascending aortic aneurysms.

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Section: Discussionmentioning

confidence: 99%

Association of Mortality and Acute Aortic Events With Ascending Aortic Aneurysm

et al. 2018

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“…Recent reports have demonstrated that statins have anti-in ammatory effects and can decrease morbidity and mortality following aneurysm repair in patients with abdominal aortic aneurysms and aneurysm expansion before operation [22][23][24][25]. Several experimental studies demonstrate that the use of statins reduces aortic aneurysm formation, suppresses in ammation in animal models, and can also improve patient survival [26,27]. A retrospective study showed that patients with AAD who used statins had signi cantly better prognosis than those who did not [28].…”

Section: Discussionmentioning

confidence: 99%

Efficiency Of Atorvastatin On In-Hospital Mortality Of Patients With Acute Aortic Dissection (Aad): Study Protocol For A Randomized, Double-Blind, Placebo-Controlled Trial

Chen

Xiong

Wang

et al. 2020

Preprint

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Background: Dyslipidemia and local inflammation at sites of lipid deposition on blood vessel walls have been demonstrated to be risk factors for patients with acute aortic dissection (AAD). Statins have anti-inflammatory and lipid-lowering effects, which suggest that statins may play an important role in prevention and treatment of AAD. Some retrospective studies show that statins can protect patients with aortic dissection. However, the effect of statins on survival of AAD patients have been scarcely investigated, especially in randomized trials. In this study, we will perform a randomized controlled trial (RCT) to evaluate the effect of statins on in-hospital mortality of AAD patients. Methods: A total of 384 subjects diagnosed with AAD in the First Affiliated Hospital of Shantou University Medical College will be recruited. Participants will be randomly divided into atorvastatin-treated or placebo groups. The primary outcome will be the in-hospital mortality. Discussion: This study is designed to verify the safety and efficacy of atorvastatin in patients with AAD. The aim is to provide a new way to improve survival as a complement to conventional drug therapy.Trial registration: Registered by Chinese Clinical Trials Registry (Registration number:ChiCTR1900023515,http://www.chictr.org.cn/edit.aspx?pid=38275&htm=4).Registered 1 June 2019.

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“…Furthermore, Jovin et al [ 9 ] showed that in patients with thoracic aneurysms (without specifying the prevalence of BAV), the annual growth rate of the thoracic aortic aneurysm in patients treated with statins (n = 46) was comparable to that of patients not treated with statins (n = 169) (0.8 vs. 0.9 mm/year, p = 0.7). Angeloni et al [ 11 ] recently published a large propensity score matched cohort study that showed a significantly smaller ascending aorta dilation rate of 0.95 mm/year in statin users compared to 1.27 mm/year in non-users. The reported dilation rates were both larger than those reported in the present study, which might be explained by the inclusion of larger ascending aortic aneurysms at baseline in the study by Angeloni et al [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, increased activity and expression of metalloproteinases have been demonstrated in histological samples of ascending aorta aneurysms of patients with BAV [ 4 ]. The pleiotropic effects of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) reduce the expression of metalloproteinases [ 5 , 6 ] and have been demonstrated to limit the growth rate of abdominal aneurysms and to improve the thoracic and abdominal aortic aneurysm rupture and dissection-free survival [ 7 – 11 ]. In patients with BAV, the use of statins has been associated with smaller aortic root and ascending aorta diameters in cross-sectional studies [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of statins on aortic root growth rate in patients with bicuspid aortic valve anatomy

Regeer

Rosendael

Kamperidis

et al. 2015

Int J Cardiovasc Imaging

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Bicuspid aortic valve (BAV) anatomy is associated with increased growth rate of the aortic root compared to tricuspid aortic valves. Statins decrease the growth rate of abdominal aneurysms; however their effect on the aortic root growth rate has not been elucidated. The present study evaluated the association between use of statins and aortic root growth in patients with BAV. A total of 199 patients (43 ± 15 years, 69 % male) with BAV who underwent ≥2 echocardiographic measurements of the aortic root ≥1 year apart were included in this retrospective observational study. Median follow-up duration was 4.7 years (interquartile range 2.7–8.3 years). Growth rate (mm/year) of the aortic root was compared between statin users (n = 41) and non-users (n = 158). Statin users were significantly older and had more cardiovascular risk factors than their counterparts. Ascending aorta diameter was significantly smaller at baseline and at follow-up in statin users compared with non-users when adjusted for coronary artery disease, age and medication. The average annual growth rate was 0.08 mm/year (95 % confidence interval 0.03–0.13) for the aortoventricular junction, 0.16 mm/year (0.11–0.21) for the sinus of Valsalva, 0.12 mm/year (0.07–0.17) for the sinotubular junction and 0.45 mm/year (0.37–0.53) for the ascending aorta. The dilation rate of the aortic segments was not different between statin users and non-users. In conclusion, in patients with BAV, although the use of statins was associated with smaller ascending aorta, the annual dilation rate of the aortic root was not influenced by the use of statins.

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Effects of statin therapy on ascending aorta aneurysms growth: A propensity-matched analysis

Cited by 40 publications

References 18 publications

Association of Mortality and Acute Aortic Events With Ascending Aortic Aneurysm

Association of Mortality and Acute Aortic Events With Ascending Aortic Aneurysm

Efficiency Of Atorvastatin On In-Hospital Mortality Of Patients With Acute Aortic Dissection (Aad): Study Protocol For A Randomized, Double-Blind, Placebo-Controlled Trial

Effect of statins on aortic root growth rate in patients with bicuspid aortic valve anatomy

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