Vascular Biology Unit, Department of Surgery, School of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.
Am Heart J. 2010 Feb;159(2):307-13. doi: 10.1016/j.ahj.2009.11.016.
Statins have been suggested to reduce expansion of abdominal aortic aneurysms (AAAs) independent of lipid-lowering effects.
We assessed the association of statin treatment and serum low-density lipoprotein (LDL) concentrations with small AAA expansion. Six hundred fifty-two patients undergoing surveillance of small AAAs were entered into the study from 5 vascular centers. In a subset, fasting lipids (n = 451) and other biomarkers (n = 216) were measured. The AAA diameter was followed by ultrasound surveillance for a median of 5 years.
Three hundred forty-nine (54%) of the patients were prescribed statins. Adjusting for other risk factors, statin prescription was not associated with AAA growth (odds ratio [OR] 1.23, 95% CI 0.86-1.76). Above-median AAA growth was positively associated with initial diameter (OR 1.78 per 4.35-mm-larger initial aortic diameter, 95% CI 1.49-2.14) and negatively associated with diabetes (OR 0.37, 95% CI 0.22-0.62). Above-median serum LDL concentration was not associated with AAA growth. Patients receiving statins had lower serum C-reactive protein concentrations but similar matrix metalloproteinase-9 and interleukin-6 concentrations to those not prescribed these medications.
We found no association between statin prescription or LDL concentration with AAA expansion. The results do not support the findings of smaller studies and suggest that statins may have no benefit in reducing AAA progression.
他汀类药物被认为可降低血脂以外的腹主动脉瘤（AAA）的扩张。
我们评估了他汀类药物治疗和血清低密度脂蛋白（LDL）浓度与小 AAA 扩张的关系。从 5 个血管中心纳入 652 例接受小 AAA 监测的患者。在亚组中，测量了空腹血脂（n=451）和其他生物标志物（n=216）。通过超声监测中位数为 5 年的时间来随访 AAA 直径。
349 例（54%）患者处方了他汀类药物。调整其他危险因素后，他汀类药物的处方与 AAA 生长无关（比值比[OR] 1.23，95%置信区间[CI] 0.86-1.76）。高于中位数的 AAA 生长与初始直径呈正相关（OR 1.78，每 4.35mm 初始主动脉直径增加，95%CI 1.49-2.14），与糖尿病呈负相关（OR 0.37，95%CI 0.22-0.62）。高于中位数的血清 LDL 浓度与 AAA 生长无关。服用他汀类药物的患者血清 C 反应蛋白浓度较低，但基质金属蛋白酶-9 和白细胞介素-6 浓度与未服用这些药物的患者相似。
我们没有发现他汀类药物的处方或 LDL 浓度与 AAA 扩张之间存在关联。这些结果不支持较小研究的发现，表明他汀类药物可能无法降低 AAA 进展的获益。
