Huang Qun, Yang Han, Lin Qiuning, Hu Ming, Meng Yuanbiao, Qin Xiao
Department of Vascular Surgery, The First Affiliated Hospital of Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China.
World J Surg. 2018 Oct;42(10):3443-3450. doi: 10.1007/s00268-018-4586-x.
No consensus exists on the effect of statin therapy on survival after abdominal aortic aneurysm (AAA) repair. The objective of this review was to systematically review the literature to investigate whether statin therapy is associated with improved outcomes after AAA repair.
We searched PubMed, Embase, and Cochrane Library to find relevant randomized controlled trials and cohort studies. Outcomes of interest included long-term mortality and short-term mortality and perioperative cardiac complications.
Nine cohort studies and one post hoc study of a randomized controlled trial were included, giving a total of 28,496 enrolled patients. Compared with nonusers of statins, statin use was associated with significantly lower long-term mortality (HR 0.57, 95% CI 0.47-0.69, I = 70.1%), short-term mortality (RR 0.60, 95% CI 0.38-0.98, I = 51.7%), and fewer perioperative cardiac complications (RR 0.46, 95% CI 0.26-0.80, I = 0%).
The results suggest that statin therapy has beneficial effects on survival after AAA repair and statins should be recommended to patients who will receive open or endovascular AAA repair. However, these findings mainly relied on data from cohort studies, and the high-quality studies are still needed to further validate our conclusions.
关于他汀类药物治疗对腹主动脉瘤（AAA）修复术后生存的影响，目前尚无共识。本综述的目的是系统回顾文献，以研究他汀类药物治疗是否与AAA修复术后改善的预后相关。
我们检索了PubMed、Embase和Cochrane图书馆，以查找相关的随机对照试验和队列研究。感兴趣的结局包括长期死亡率、短期死亡率和围手术期心脏并发症。
纳入了9项队列研究和1项随机对照试验的事后分析研究，共有28496名登记患者。与未使用他汀类药物的患者相比，使用他汀类药物与显著降低的长期死亡率（HR 0.57，95%CI 0.47-0.69，I=70.1%）、短期死亡率（RR 0.60，95%CI 0.38-0.98，I=51.7%）以及更少的围手术期心脏并发症（RR 0.46，95%CI 0.26-0.80，I=0%）相关。
结果表明，他汀类药物治疗对AAA修复术后的生存有有益影响，应推荐给将接受开放或血管内AAA修复的患者。然而，这些发现主要依赖于队列研究的数据，仍需要高质量的研究来进一步验证我们的结论。
