Abstract
The aim was to summarise the evidence from published epidemiological studies investigating the efficacy of statin therapy on long term survival in patients after abdominal aortic aneurysm (AAA) repair. This study was a systematic review with critical appraisal and meta-analysis of observational studies. A systematic literature search was carried out throughout February 2020, revealing 14 eligible cohort studies of which 11 were judged to be of high quality. A random effects model was used to synthesise results, and heterogeneity between studies examined by subgroup and meta-regression analyses considering patient and study related variables. Small study effect was evaluated. The pooled estimate showed that statin treatment among 69790 AAA patients with a median follow up of 3.1 years was associated with a 35% relative reduction in total mortality (rate ratio 0.65, 95% confidence interval 0.57-0.73) with moderate heterogeneity (I2= 68%) and no small study effect. Evidence from this systematic review indicates a beneficial effect of statins on long term survival in patients treated by AAA repair.
Highlights
The prophylactic treatment with statins in cardiac and noncardiac atherosclerotic disease is associated with improved survival and is well documented.[1]
The entire cohort comprised 69 790 patients after abdominal aortic aneurysm (AAA), of whom on average 48% were on statin therapy
The pooled estimate (Fig. 2) indicates a 35% relative risk (RR) mortality reduction in AAA patients on statin therapy compared with non-users (RR 0.65, 95% confidence interval (CI) 0.57e0.73) with moderate between study heterogeneity (I2 1⁄4 68%)
Summary
The prophylactic treatment with statins in cardiac and noncardiac atherosclerotic disease is associated with improved survival and is well documented.[1] the same result in patients with abdominal aortic aneurysm (AAA) had not been clear previously. Later results have shown that prophylactic treatment with statins should be included because of the effect on reduction in growth progression, rupture, and lower rates of peri-operative mortality.[2] Statins have been shown to be independent predictors of decreased long term mortality after AAA.3e7. The aim of the study was to search the literature to study the long term effects of statins after open surgical repair (OSR) and endovascular aneurysm repair (EVAR) in general and to search for possible trends in the choice of treatment. A systematic review and meta-analysis was conducted to clarify this issue
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