Department of Cardiovascular Surgery, Shizuoka Medical Center, 762-1 Nagasawa, Shimizu-cho, Shizuoka 411-8611, Japan.
Eur J Vasc Endovasc Surg. 2012 Sep;44(3):287-92. doi: 10.1016/j.ejvs.2012.06.021. Epub 2012 Jul 21.
To determine whether statin therapy reduces the growth rate of small abdominal aortic aneurysms (AAAs).
A meta-analysis and a meta-regression of comparative studies.
Eligible studies were randomized controlled trials or observational comparative studies of statin therapy versus placebo or no statin, enrolling individuals with small (<55 mm in diameter) AAAs and reporting AAA growth rate as an outcome.
Study-specific estimates (standardized mean differences [SMDs]) were combined in the fixed- and random-effects model.
Seven adjusted and 4 unadjusted observational comparative studies enrolling 4647 patients with a small AAA were identified. Pooled analysis of all 11 studies suggested a significant reduction in AAA growth rate among patients assigned to statin therapy versus no statin (SMD, -0.420; 95% confidence interval [CI], -0.651 to -0.189). Combining the 7 high-quality studies providing adjusted data for growth rates generated an attenuated but still statistically significant result favoring statin therapy (SMD, -0.367; 95% CI, -0.566 to -0.168). The meta-regression coefficient for the baseline diameter was statistically significant (-0.096; 95% CI, -0.132 to -0.061).
Statin therapy is likely effective in prevention of the growth of small AAAs, and may be more beneficial as the baseline diameter increases.
确定他汀类药物治疗是否能降低小的腹主动脉瘤（AAA）的生长速度。
荟萃分析和比较研究的荟萃回归。
符合条件的研究是随机对照试验或他汀类药物治疗与安慰剂或无他汀类药物治疗的观察性比较研究，纳入了小（直径<55mm）AAA 的个体，并将 AAA 生长速度作为结果进行报告。
采用固定效应模型和随机效应模型对研究特定的估计值（标准化均数差[SMD]）进行合并。
确定了 7 项调整后的和 4 项未经调整的观察性比较研究，共纳入 4647 名小 AAA 患者。对所有 11 项研究的汇总分析表明，与未接受他汀类药物治疗的患者相比，接受他汀类药物治疗的患者的 AAA 生长速度显著降低（SMD，-0.420；95%置信区间[CI]，-0.651 至-0.189）。合并 7 项提供了调整后增长率数据的高质量研究，结果仍倾向于他汀类药物治疗（SMD，-0.367；95%CI，-0.566 至-0.168）。基线直径的荟萃回归系数具有统计学意义（-0.096；95%CI，-0.132 至-0.061）。
他汀类药物治疗可能有效预防小的 AAA 生长，且随着基线直径的增加，可能更有益。
