Statins Reduce Extensive Aortic Atheromas in Patients with Abdominal Aortic Aneurysms

Nemoto, Masaru; Hoshina, Katsuyuki; Takayama, Tadatoshi; Miura, Sumio; Nakazawa, Tatsu; Kato, Masaaki; Shigematsu, Kunihiro; Miyata, Tetsuro; Watanabe, Toshiaki

doi:10.3400/avd.oa.13-00065

Cited by 16 publications

(7 citation statements)

References 33 publications

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“…It has been shown in a pilot study that statin use had a pleiotropic effect on aortic wall atheroma that both stabilized and reduced the size of the plaque. 9 When looking at the effect of statin medication on the expansion rate and the risk of rupture in the aortic wall of AAA patients, irrespective of the decrease in serum cholesterol levels, there was also cellular activity. This activity included effects on endothelial cells, smooth muscle cells, platelets, monocytes/macrophages, and the inflammatory process/ cascade.…”

Section: Discussionmentioning

confidence: 99%

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

Mathisen

Abdelnoor

2017

Vasc Med

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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.

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Section: Discussionmentioning

confidence: 99%

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

Mathisen

Abdelnoor

2017

Vasc Med

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“…Surgical repair is currently the only option for preventing AAA rupture 4 and, notably, endovascular treatment improves the surgical outcome in AAA treatment 5,6 . Recently, we found that metabolic abnormalities, especially serum dyslipidemia, are associated with AAA progression and mortality 7,8 . Proprotein convertase subtilisin/kexin type 9 PCSK9 is a secreted enzyme that increases the degradation of surface low-density lipoprotein receptors LDLRs , decreasing the removal of LDL-bound cholesterol from the blood.…”

Section: Introductionmentioning

confidence: 99%

Proprotein Convertase Subtilisin/Kexin Type 9 Is Associated with Degenerating Adipocytes in Abdominal Aortic Aneurysm

et al. 2018

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Abdominal aortic aneurysm (AAA) is a common disease among the elderly. Recently, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have been indicated as useful therapeutic tools for the treatment of cardiovascular diseases. The aim of this study was to elucidate the role of PCSK9 in the pathogenesis of AAA. We used fluorescence immunohistochemistry to assess the expression of PCSK9 in aortic tissues resected from 24 patients with AAA. Histological examination showed that PCSK9 expression in the adventitia region of the aneurysms was decreased in AAA samples. In the same region, the expression of CD36 increased. We hypothesized that CD36 expression might upregulate the transport of fatty acids into cells such as the adipocytes, and subsequently cause degradation of the adventitia in the aortic wall, contributing to AAA development.

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“…The latter resulted in better survival free from complications such as dissection, rupture or need for repair for those patients receiving statin therapy. To date, no other study investigated the effect of statins on the dilatation of ascending aorta aneurysms, but only on the abdominal aorta [7,8], and on the whole thoracic aorta including aortic arch and thoracic descending aorta [9]. Furthermore, that retrospective study [9] was not adjusted for selection bias.…”

Section: Discussionmentioning

confidence: 95%

“…Etiology is multifaceted, involving systemic hypertension, connective tissue disorders, proinflammatory mediators such as macrophages, T-cells, B-cells and neutrophils, as well as multiple pro-inflammatory transcription factors [6]. Previous studies have shown that statin therapy is likely effective in prevention of the growth of small abdominal aorta aneurysms [7,8]. To date, only one study investigated the effect of statin therapy on thoracic aorta aneurysm growth [9], and found a significant correlation between statin therapy and a decreased progression to dissection, rupture, or death; although no significant difference was found with regard to the aortic root, and the investigation included the whole thoracic aorta.…”

Section: Introductionmentioning

confidence: 99%

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

Angeloni¹,

Vitaterna²,

Pirelli³

et al. 2015

International Journal of Cardiology

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Statins Reduce Extensive Aortic Atheromas in Patients with Abdominal Aortic Aneurysms

Cited by 16 publications

References 33 publications

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

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

Proprotein Convertase Subtilisin/Kexin Type 9 Is Associated with Degenerating Adipocytes in Abdominal Aortic Aneurysm

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

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