Department of Medicine, Yale University, New Haven, Connecticut, USA.
Am J Cardiol. 2012 Apr 1;109(7):1050-4. doi: 10.1016/j.amjcard.2011.11.038. Epub 2012 Jan 3.
The potential of medical therapy to influence the courses and outcomes of patients with thoracic aortic aneurysms is not known. The aim of this study was to determine whether statin intake is associated with improved long-term outcomes in these patients. A total of 649 patients with thoracic aortic aneurysms were studied, of whom 147 were taking statins at their first presentation and 502 were not. After a median follow-up period of 3.6 years, 30 patients (20%) taking statins had died, compared with 167 patients (33%) not taking statins (hazard ratio 0.68, 95% confidence interval 0.46 to 1, p = 0.049); 87 patients (59%) taking statins reached the composite end point of death, rupture, dissection, or repair compared with 378 patients (75%) not taking statins (hazard ratio 0.72, 95% confidence interval 0.57 to 0.91, p = 0.006). After adjustments for co-morbidities, the association between statin therapy and the composite end point was driven mainly by a reduction in aneurysm repairs (hazard ratio 0.57 95% confidence interval 0.4 to 0.83, p = 0.003). On Kaplan-Meier analysis, the survival rate of patients taking statins was significantly better (p = 0.047). In conclusion, the intake of stains was associated with an improvement in long-term outcomes in this cohort of patients with thoracic aortic aneurysms. This was driven mainly by a reduction in aneurysm repairs.
医学治疗对胸主动脉瘤患者病程和结局的影响尚不清楚。本研究旨在确定他汀类药物的使用是否与这些患者的长期预后改善相关。共纳入了 649 例胸主动脉瘤患者，其中 147 例患者在首次就诊时正在服用他汀类药物，502 例患者未服用。中位随访 3.6 年后，30 例（20%）服用他汀类药物的患者死亡，而未服用他汀类药物的患者有 167 例（33%）（风险比 0.68，95%置信区间 0.46 至 1，p=0.049）；87 例（59%）服用他汀类药物的患者达到了死亡、破裂、夹层或修复的复合终点，而未服用他汀类药物的患者有 378 例（75%）（风险比 0.72，95%置信区间 0.57 至 0.91，p=0.006）。在调整了合并症后，他汀类药物治疗与复合终点之间的关联主要归因于动脉瘤修复的减少（风险比 0.57，95%置信区间 0.4 至 0.83，p=0.003）。在 Kaplan-Meier 分析中，服用他汀类药物的患者的生存率显著提高（p=0.047）。总之，在本队列的胸主动脉瘤患者中，他汀类药物的使用与长期预后的改善相关。这主要归因于动脉瘤修复的减少。
