Statins Reduce Abdominal Aortic Aneurysm Growth, Rupture, and Perioperative Mortality: A Systematic Review and Meta-Analysis

Background There are no recognized pharmacological treatments for abdominal aortic aneurysms ( AAA ), although statins are suggested to be beneficial. We sought to summarize the literature regarding the effects of statins on human AAA growth, rupture, and 30-day mortality. Methods and Results We con...

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Bibliographic Details
Published in:Journal of the American Heart Association 2018-10, Vol.7 (19), p.e008657-e008657
Main Authors: Salata, Konrad, Syed, Muzammil, Hussain, Mohamad A, de Mestral, Charles, Greco, Elisa, Mamdani, Muhammad, Tu, Jack V, Forbes, Thomas L, Bhatt, Deepak L, Verma, Subodh, Al-Omran, Mohammed
Format: Article
Language:English
Subjects:
aneurysm
Aneurysm, Ruptured - mortality
Aneurysm, Ruptured - prevention & control
Aneurysm, Ruptured - surgery
Aortic Aneurysm, Abdominal - drug therapy
Aortic Aneurysm, Abdominal - mortality
Aortic Aneurysm, Abdominal - surgery
Disease Progression
Global Health
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
meta‐analysis
Perioperative Care - methods
rupture
statin
Survival Rate - trends
systematic review
Systematic Review and Meta‐analysis
Vascular Surgical Procedures - methods
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Summary:Background There are no recognized pharmacological treatments for abdominal aortic aneurysms ( AAA ), although statins are suggested to be beneficial. We sought to summarize the literature regarding the effects of statins on human AAA growth, rupture, and 30-day mortality. Methods and Results We conducted a systematic review and meta-analysis of randomized and observational studies using the Cochrane CENTRAL database, MEDLINE , and EMBASE up to June 15, 2018. Review, abstraction, and quality assessment were conducted by 2 independent reviewers, and a third author resolved discrepancies. Pooled mean differences and odds ratios with 95% confidence intervals were calculated using random effects models. Heterogeneity was quantified using the I statistic, and publication bias was assessed using funnel plots. Our search yielded 911 articles. One case-control and 21 cohort studies involving 80 428 patients were included. The risk of bias was low to moderate. Statin use was associated with a mean AAA growth rate reduction of 0.82 mm/y (95% confidence interval 0.33, 1.32, P=0.001, I =86%). Statins were also associated with a lower rupture risk (odds ratio 0.63, 95% confidence interval 0.51, 0.78, P
ISSN:2047-9980
2047-9980
DOI:10.1161/jaha.118.008657