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他汀类药物治疗对血管腔内主动脉修复术后动脉瘤囊缩小的影响。

Influence of Statin Therapy on Aneurysm Sac Regression after Endovascular Aortic Repair.

作者信息

Kim Wonho, Gandhi Ripal T, Peña Constantino S, Herrera Raul E, Schernthaner Melanie B, Acuña Juan M, Becerra Victor N, Katzen Barry T

机构信息

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.

出版信息

J Vasc Interv Radiol. 2017 Jan;28(1):35-43. doi: 10.1016/j.jvir.2016.09.010. Epub 2016 Nov 16.

Abstract

PURPOSE

To determine whether statin therapy is associated with abdominal aortic aneurysm (AAA) sac regression after endovascular aneurysm repair (EVAR).

MATERIALS AND METHODS

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.

RESULTS

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).

CONCLUSIONS

Statin therapy had no effect on AAA sac regression at 2 years. There is insufficient evidence to recommend statin therapy for AAA sac regression.

摘要

目的

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。

材料与方法

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。

结果

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。

结论

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。

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