Abstract 15204: The Effect of Primary Prevention Statin Therapy on Mortality in Persons With Aortic Atherosclerosis
Introduction: The prevalence of aortic atherosclerosis has increased as a result of greater availability and use of medical imaging. The role of statin therapy in subjects with aortic atherosclerosis, in particular by predicted 10-year risk for atherosclerotic cardiovascular disease (ASCVD), remains unknown.
Objective: To determine the effect of primary prevention statin therapy in subjects with aortic atherosclerosis.
Methods: We identified 116,720 consecutive subjects with aortic atherosclerosis who did not have known coronary artery disease or stroke between 2009-2013. Propensity score for statin use was calculated using logistic regression and used to match statin users and non-users 1:1. The covariates included in the model were: demographics, cardiovascular risk factors, comorbidities, medications, and resource utilization. Cox proportional hazards models for all-cause mortality were then used to calculate hazard ratios for statin users vs. non-users in the matched cohort. The 10-year estimated ASCVD risk was calculated using the Pooled Cohort Equation.
Results: The propensity matched cohort was comprised of 78,050 subjects; 39,025 statin users and 39,025 non-users. The groups were well matched for baseline variables and confounders. The mean (SD) age was 73 (IQR, 67-80) years. The median follow-up was 1.5 years. The risk for all-cause mortality was significantly lower for statin-users, including stratification by estimated 10-year ASCVD risk. For the cohort with ASCVD ≤ 7.5% (n= 7770), for whom there is no guideline based recommendation for statin therapy, all-cause mortality was lower for statin users (HR: 0.56 [95% CI: 0.4-0.69]; p<0.001).
Conclusion: In a propensity matched cohort with aortic atherosclerosis, statin therapy was associated with reduction in all-cause mortality. Aortic atherosclerosis may represent a high-risk cohort for whom treatment with statin therapy should be considered irrespective of estimated ASCVD risk.
Author Disclosures: R.R. Razi: None. S.S. Brar: None. M.B. Jorgensen: None. I. Finn: None. D. Zisook: None.
- © 2016 by American Heart Association, Inc.