Diehm N, Becker G, Katzen B, Benenati J, Kovacs M, Dick F
Department of Heart and Vessel, Division of Angiology Inselspital, Bern University Hospital, and University of Bern, Switzerland.
Vasa. 2008 Aug;37(3):241-9. doi: 10.1024/0301-1526.37.3.241.
Purpose of this study was to compare the correlation of statin use with long-term mortality in patients with abdominal (AAA) and thoracic aortic aneurysm (TAA).
We compared long-term survival of 731 AAA and 59 TAA patients undergoing elective endovascular repair (EVAR). Kaplan-Meier survival curves were compared by the log-rank method. Propensity score-adjusted multivariable logistic regression models were used to determine independent associations of statin use on vital status after EVAR.
Statin use was associated with decreased long-term mortality in AAA patients in bivariate and multivariable regression analysis, in which the effect of propensity to receive a statin was considered (adjusted HR: .613, 95%-CI: .379- .993, p = .047) whereas mortality of TAA patients was not associated with use of statins (adjusted HR: 1.795, 95%-CI: .147 -21.942, p = .647).
Use of statins is an independent predictor of decreased mortality after elective EVAR in AAA, but not in TAA patients. These findings indirectly support the concept of a distinct pathogenesis of AAA and TAA.
本研究的目的是比较他汀类药物的使用与腹主动脉瘤（AAA）和胸主动脉瘤（TAA）患者长期死亡率之间的相关性。
我们比较了731例接受择期血管内修复术（EVAR）的AAA患者和59例TAA患者的长期生存率。采用对数秩检验比较Kaplan-Meier生存曲线。倾向评分调整的多变量逻辑回归模型用于确定他汀类药物使用与EVAR术后生命状态的独立关联。
在双变量和多变量回归分析中，他汀类药物的使用与AAA患者长期死亡率降低相关，其中考虑了接受他汀类药物的倾向效应（调整后的风险比：0.613，95%置信区间：0.379 - 0.993，p = 0.047），而TAA患者的死亡率与他汀类药物的使用无关（调整后的风险比：1.795，95%置信区间：0.147 - 21.942，p = 0.647）。
他汀类药物的使用是AAA患者择期EVAR术后死亡率降低的独立预测因素，但不是TAA患者的独立预测因素。这些发现间接支持了AAA和TAA具有不同发病机制的概念。
