Kim Wonho, Gandhi Ripal T, Peña Constantino S, Herrera Raul E, Schernthaner Melanie B, Acuña Juan M, Becerra Victor N, Katzen Barry T
Division of Interventional Radiology, Miami Cardiac and Vascular Institute, Miami, Florida; Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida; Division of Cardiology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea.
Division of Interventional Radiology, Miami Cardiac and Vascular Institute, Miami, Florida.
J Vasc Interv Radiol. 2017 Jan;28(1):35-43. doi: 10.1016/j.jvir.2016.09.010. Epub 2016 Nov 16.
To determine whether statin therapy is associated with abdominal aortic aneurysm (AAA) sac regression after endovascular aneurysm repair (EVAR).
A total of 109 patients treated with EVAR were retrospectively analyzed (no-statin group, n = 45; statin group, n = 64). The primary endpoint was the incidence of AAA sac regression. To investigate independent predictors of AAA sac regression, regression analysis was performed. The mean age was 74 years (range, 55-90 y), and 87.2% of patients were men.
The no-statin group had higher rates of AAA sac regression than the statin group at 1 year (no-statin group, 66.7%; statin group, 45.3%; P = .028). The incidence of AAA sac regression increased over time in the statin group, and no statistical difference was seen between the two groups at 2 years (no-statin group, 66.7%; statin group, 57.8%; P = .350). The difference between the changes in maximum AAA diameter was significant between groups at 1 year (no-statin group vs statin group, -4.9 mm ± 5.9; P = .041), but the difference did not reach statistical significance at 2 years (no-statin group, -10.0 mm ± 10.1; statin group, -8.0 mm ± 9.6; P = .306). Statin therapy was not associated with AAA sac regression on univariate (odds ratio [OR], 0.685; 95% confidence interval [CI], 0.310-1.516; P = .351) and multivariate analyses (OR, 0.617; 95% CI, 0.215-1.772; P = .369).
Statin therapy had no effect on AAA sac regression at 2 years. There is insufficient evidence to recommend statin therapy for AAA sac regression.
确定他汀类药物治疗是否与血管腔内修复术(EVAR)后腹主动脉瘤(AAA)瘤腔缩小相关。
对109例行EVAR治疗的患者进行回顾性分析(非他汀类药物组,n = 45;他汀类药物组,n = 64)。主要终点是AAA瘤腔缩小的发生率。为研究AAA瘤腔缩小的独立预测因素,进行了回归分析。平均年龄为74岁(范围55 - 90岁),87.2%的患者为男性。
1年时,非他汀类药物组AAA瘤腔缩小率高于他汀类药物组(非他汀类药物组,66.7%;他汀类药物组,45.3%;P = 0.028)。他汀类药物组AAA瘤腔缩小的发生率随时间增加,两组在2年时无统计学差异(非他汀类药物组,66.7%;他汀类药物组,57.8%;P = 0.350)。1年时两组间AAA最大直径变化的差异有统计学意义(非他汀类药物组与他汀类药物组,-4.9 mm ± 5.9;P = 0.041),但2年时差异未达到统计学意义(非他汀类药物组,-10.0 mm ± 10.1;他汀类药物组,-8.0 mm ± 9.6;P = 0.306)。单因素分析(优势比[OR],0.685;95%置信区间[CI],0.310 - 1.516;P = 0.351)和多因素分析(OR,0.617;95% CI,0.215 - 1.772;P = 0.369)显示他汀类药物治疗与AAA瘤腔缩小无关。
他汀类药物治疗在2年时对AAA瘤腔缩小无影响。没有足够证据推荐使用他汀类药物治疗来促进AAA瘤腔缩小。