The influence of statins on aortic aneurysm after operation

Liao, Kuang-Ming; Wang, Shih‐Wei; Lu, Chun-Hui; Huang, Yaw‐Bin

doi:10.1097/md.0000000000015368

Cited by 4 publications

(5 citation statements)

References 19 publications

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“…Post-treatment statin use, which was defined as persistent statin use 30 days after the procedure, was associated with a significantly lower mortality rate. However, only 12.2% (199/1633) of the whole study population were prescribed statins after AAA repair [22]. In our cohort, 38.1% (3386/8893) were using statins before EVAR and, among them, 81.7% maintained statin use after the procedure.…”

Section: Discussionmentioning

confidence: 63%

Role of Statins after Endovascular Repair of Abdominal Aortic Aneurysms: A Nationwide Population-Based Study

Lee

Choo

et al. 2023

JCM

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The role of statins after endovascular abdominal aortic aneurysm repair (EVAR) has not been well established in an Asian context. In this study, the use of statins and their association with long-term health outcomes were evaluated in patients undergoing EVAR using the Korean National Health Insurance Service database. Among the 8893 patients who underwent EVAR from 2008 to 2018, 3386 (38.1%) were on statins prior to the procedure. Patients using statins had a higher prevalence of comorbidities, such as hypertension (88.4% vs. 71.5%), diabetes mellitus (24.5% vs. 14.1%), and heart failure (21.6% vs. 13.1%), compared with non-users (all p < 0.001). After propensity score matching, statin use prior to EVAR was associated with a lower risk of all-cause mortality (HR 0.85, 95% CI 0.78–0.92, p < 0.001) and cardiovascular mortality (HR 0.66, 95% CI 0.51–0.86, p = 0.002). Statin use following EVAR was associated with a lower risk of adverse events, but not significantly so. Patients on statins both preceding and following EVAR had a lower risk of all-cause mortality (HR 0.82, 95% CI 0.73–0.91, p < 0.001) and cardiovascular mortality (HR 0.62, 95% CI 0.44–0.87, p = 0.007), compared with statin non-users. Among Korean patients undergoing EVAR, the persistent use of statins prior to and after the procedure was associated with a lower risk of mortality, compared with non-statin users.

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Section: Discussionmentioning

confidence: 63%

Role of Statins after Endovascular Repair of Abdominal Aortic Aneurysms: A Nationwide Population-Based Study

Lee

Choo

et al. 2023

JCM

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“…Another meta-analysis showed the long-term outcome bene it of stain therapy in patients with AAA without any signi icant impact on peri operative mortality [31]. This was also observed in another study done by Liao et al [32]. This bene it is derived due to the reduction in the in lammatory markers and the levels of the matrix metalloproteinases [33].…”

Section: Treatmentmentioning

confidence: 69%

Association of Coronary Artery Disease and Abdominal Aortic Aneurysm – A Narrative Review

A¹

2021

RIJCCM

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Studies have shown a strong association between coronary artery disease (CAD) and Abdominal Aortic Aneurysm (AAA). CAD is an independent predictor for developing AAA. The strong risk factors which were associated with the development of AAA were older age, male sex, hypertension, smoking, dyslipidemia, respiratory disease, cerebrovascular disease, claudication, and renal insuffi ciency in predicting the development of AAA. The prevalence of AAA among patients with angiographyverifi ed CAD was higher in men. It also increased to 8.6% in men aged above 65 years. They also found that 2.5% of patients with normal coronary profi le, 4.3% of patients with single vessel disease, 5.7% of patients with double vessel disease and 14.4% of patients with triple vessel disease on angiogram had AAA. The Pathological features like chronic infl ammation, degradation of the extracellular matrix and apoptosis of the vascular smooth muscle cells are common to both CAD and AAA. The vascular Smooth Muscle Cell (VSMC) plays an important role in the pathogenesis of coronary artery disease and aortic aneurysms. Another mechanism identifi ed in these VSMCs is the role of ubiquitin-like containing PHD and RING fi nger domains 1 (UHRF1) as the epigenetic master regulator of VSMC plasticity. Large symptomatic AAA with signifi cant CAD, a combined procedure should be the preferred approach. Asymptomatic AAA and CAD, a staged approach of CABG followed by AAA repair within two weeks should be performed to minimize the risk of AAA rupture. A one-time ultrasound screening for AAAs in men or women 65 to 75 years of age with a history of tobacco use, in fi rst-degree relatives of patients who present with an AAA, in men or women older than 75 years with a history of tobacco use is recommended.

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“…63 Previous meta-analysis demonstrated that patients with statin treatment were associated with a decreased growth rate of AA. 64,65 Controversy also remains because of different clinical outcomes that some studies have indicated a beneficial association between statin use and the progression of AAA, [66][67][68][69] whereas others failed to draw the same conclusion as the former. 70,71 Therefore, there is not yet enough evidence supporting that statins act as effective pharmaceutical agents to stabilize AAA, although the benefits of statins are impressive on animal models.…”

Section: Statinsmentioning

confidence: 99%

Current Pharmacological Management of Aortic Aneurysm

Xiang

Zhu

et al. 2021

Journal of Cardiovascular Pharmacology

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Aortic aneurysm (AA) remains one of the primary causes of death worldwide. Of the major treatments, prophylactic operative repair is used for AA to avoid potential aortic dissection or rupture. To halt the development of AA and alleviate its progression into aortic dissection, pharmacological treatment has been investigated for years. Currently, b-adrenergic blocking agents, losartan, irbesartan, angiotensin-converting-enzyme inhibitors, statins, antiplatelet agents, doxycycline, and metformin have been investigated as potential candidates for preventing AA progression. However, the paradox between preclinical successes and clinical failures still exists, with no medical therapy currently available for ideally negating the disease progression. This review describes the current drugs used for pharmacological management of AA and their individual potential mechanisms. Preclinical models for drug screening and evaluation are also discussed to gain a better understanding of the underlying pathophysiology and ultimately find new therapeutic targets for AA.

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The influence of statins on aortic aneurysm after operation

Cited by 4 publications

References 19 publications

Role of Statins after Endovascular Repair of Abdominal Aortic Aneurysms: A Nationwide Population-Based Study

Role of Statins after Endovascular Repair of Abdominal Aortic Aneurysms: A Nationwide Population-Based Study

Association of Coronary Artery Disease and Abdominal Aortic Aneurysm – A Narrative Review

Current Pharmacological Management of Aortic Aneurysm

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