Abstract 4527: Statins Improve the Long-Term Clinical Outcomes of Patients With Thoracic Aortic Aneurysms
Introduction. Thoracic aortic aneurysms are usually treated surgically, but the potential of medical therapy to influence their course and outcome is not known. Statins are widely-used drugs in patients with cardiovascular disease and some studies suggest that they are of benefit in patients with abdominal aortic aneurysms. We investigated if statins have favorable effects on the long-term outcomes of patients with thoracic aortic aneurysms.
Methods and Results. We studied 895 patients from the Yale database of thoracic aortic aneurysms. At inclusion in the database 147 patients were taking statins and 502 were not. The statin intake was not known in 246 patients. Aneurysm diameter was similar in patients using statins at presentation compared to the patients not taking statins (5.12±1.22 vs. 5.17±1.34 cm, respectively; P=0.70). After a median follow up of 3.6 years (range 0.001- 10 years), 30 (20%) patients taking statins died compared to 167 (33%) patients not taking statins (hazard ratio [HR] 0.68; 95% confidence interval [CI] 0.46 –1; P=0.049); 43 (29%) patients taking statins reached the endpoint of death, rupture or dissection compared to 226 (45%) patients not taking statins (HR 0.75; 95% CI 0.54 –1.03; P=0.08). On multivariate analysis, after adjustment for other factors, patients taking statins had a hazard ratio of 0.62 (95% CI 0.35–1.08; P=0.09) for death and of 0.80 (95% CI 0.52–1.23; P=0.31) for death, rupture or dissection. After adjustment with imputed data, patients taking statins had a hazard ratio of 0.70 (95% CI 0.48 –1.04; P=0.09) for death and 0.75 (95% CI 0.54 –1.04; P=0.09) for death, rupture or dissection. On Kaplan-Meier analysis, the 10 year survival rate of patients taking statins was significantly better compared to the survival of the patients not taking statins (P=0.047). The difference between the aneurysm rates of growth in patients taking statins and patients not taking statins was not statistically significant (0.08 vs. 0.09 cm/year, respectively; P=0.67).
Conclusion. The intake of stains reduced the long-term risk of death in this group of patients with thoracic aortic aneurysms. The slowing of aneurysm growth did not seem to be the main mechanism responsible for these effects.