Abstract
Background
The aim was to investigate the effects of statin therapy on abdominal aortic aneurysm (AAA) disease.
Methods
PubMed, the Cochrane Library, Embase and ClinicalTrials.gov were searched for all studies on any clinical effect of statin therapy on AAA. Outcomes were selected based on their inclusion in two or more studies: AAA expansion rate, 30-day mortality, and short- and long-term postoperative mortality. The data were subjected to meta-analysis by outcome.
Results
Twelve cohort studies were selected for inclusion involving 11 933 individuals. Meta-analysis of four studies examining all-cause postoperative mortality showed a significant improvement with statin therapy at 1, 2 and 5 years (odds ratio (OR) at 5 years 0ยท57, 95 per cent confidence interval (c.i.) 0ยท42 to 0ยท79; P < 0ยท001) with minimal heterogeneity between the four included studies. There was no significant difference in 30-day mortality after AAA treatment in patients on statin therapy (OR 0ยท22, 0ยท02 to 2ยท90; P = 0ยท25). Sensitivity analysis including four high-quality studies examining AAA expansion rates showed no significant difference with statin therapy: standardized mean difference โ0ยท14 (95 per cent c.i. โ0ยท33 to โ0ยท05) mm/year (P = 0ยท16).
Conclusion
The claim of a reduction in AAA expansion rate with statin therapy is based on low-quality evidence and was not significant on meta-analysis. However, statin therapy did appear to improve all-cause survival after AAA repair.