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Statins may improve survival after aneurysm repair
Statin therapy at the outset of a study involving patients undergoing endovascular or open abdominal aortic aneurysm repair was associated with a significant improvement in long-term mortality.
The researchers noted that data on the impact of statin therapy on survival after aneurysm repair remains inconclusive. They conducted a post-hoc analysis of a randomized trial to investigate whether statins can impact survival in patients who have undergone open and endovascular abdominal aortic aneurysm repair, and to identify other risk factors for survival in this patient population.
The study included 351 patients randomly assigned to open abdominal aortic aneurysm repair or endovascular repair. At inclusion, 135 patients were receiving lipid-lowering medications and 216 were not.
The mortality rate at 6 year follow-up was 33.6%.
The researchers used a number of factors to determine what influenced survival, including statin therapy; baseline characteristics; Society for Vascular Surgery/International Society for Cardiovascular Surgery risk factors; aneurysm size; reinterventions; antiplatelet or anticoagulant agents; and beta-blockers.
An independent association between statin therapy at study inclusion and improved overall survival after open or endovascular repair were reported (HR=0.5; 95% CI, 0.3-0.8). A significant association was also observed between statins and reduced incidence of CV death (HR=0.4; 95% CI, 0.2-0.9).
Poor survival after open and endovascular aneurysm repair occurred in patients with a number of risk factors, including age >70 years (HR=3.4; 95% CI, 2.2-5), a history of cardiac disease at baseline (HR=1.9; 95% CI, 1.3-2.8) and moderate/severe tobacco use (HR=1.7; 95% CI, 1.2-2.5).
No significant association with poor long-term survival was reported for factors such as gender, aneurysm size, the necessity of reintervention, pulmonary disease, renal disease, carotid disease, hypertension, diabetes mellitus, antiplatelet or anticoagulant agents and beta-blockers (P>.05).
“Despite the limitations of a post-hoc analysis of a prospectively maintained trial, we conclude that statin therapy at the beginning of the trial is independently associated with improved long-term survival after open or endovascular aneurysm repair,” the researchers wrote.
Disclosure: One researcher reports being a consultant for Gore and Cordis.