Department of Cardiology, Affiliated Hospital of Qinghai University, Xining, China.
Department of Geriatric Diseases, Zaozhuang Mental Health Center, Zaozhuang, China.
J Cardiovasc Pharmacol. 2019 Apr;73(4):232-240. doi: 10.1097/FJC.0000000000000653.
Statins have been suggested in previous studies to play a protective role in experimental cerebral aneurysm (CA) models; however, no evidence supports that the application of statins can protect against aneurysm rupture in humans, and the risks of lipid levels and aneurysms remain unknown. Therefore, this meta-analysis aimed to summarize and update the epidemiological evidence to systematically assess the relationships of statin therapy and hyperlipidemia with the incidence, rupture, postrepair mortality, and all-cause mortality of abdominal aortic aneurysm (AAA) and CA. Related studies were initially retrieved from the electronic databases PubMed, Embase, and Cochrane Library from inception to August 4, 2018. Subsequently, 33 studies were enrolled into this meta-analysis, and the maximum adjusted risk ratios (RRs) as well as the corresponding 95% confidence intervals were extracted. Finally, a total of 32 observational studies involving 150,134 participants were enrolled into this meta-analysis. The RRs of statin therapy for AAA incidence, AAA rupture, CA rupture, postrepair mortality, all-cause mortality, and adverse events were 1.83 (0.56-5.98), 0.67 (0.47-0.97), 0.50 (0.18-1.36), 0.60 (0.48-0.74), 0.66 (0.58-0.75), and 0.58 (0.47-0.71), respectively. Besides, the RR of hyperlipidemia for CA rupture was 0.79 (0.67-0.93). Our findings suggested that statin therapy could reduce the risks of AAA rupture, postrepair mortality, all-cause mortality, and adverse events, without inducing the risk of AAA incidence or CA rupture, and that hyperlipidemia was associated with a lower risk of CA rupture.
他汀类药物在先前的研究中被认为在实验性脑动脉瘤 (CA) 模型中发挥保护作用; 然而，没有证据表明他汀类药物的应用可以防止人类动脉瘤破裂，并且血脂水平和动脉瘤的风险仍不清楚。因此，本荟萃分析旨在总结和更新流行病学证据，系统评估他汀类药物治疗和高脂血症与腹主动脉瘤 (AAA) 和 CA 的发生率、破裂、修复后死亡率和全因死亡率的关系。最初从电子数据库 PubMed、Embase 和 Cochrane Library 中检索到相关研究，检索时间从建库至 2018 年 8 月 4 日。随后，共纳入 33 项研究进行荟萃分析，并提取最大调整后的风险比 (RR) 及其相应的 95%置信区间。最终，共有 32 项观察性研究纳入了 150134 名参与者。他汀类药物治疗对 AAA 发生率、AAA 破裂、CA 破裂、修复后死亡率、全因死亡率和不良事件的 RR 分别为 1.83 (0.56-5.98)、0.67 (0.47-0.97)、0.50 (0.18-1.36)、0.60 (0.48-0.74)、0.66 (0.58-0.75)和 0.58 (0.47-0.71)，高脂血症对 CA 破裂的 RR 为 0.79 (0.67-0.93)。我们的研究结果表明，他汀类药物治疗可以降低 AAA 破裂、修复后死亡率、全因死亡率和不良事件的风险，而不会增加 AAA 发生率或 CA 破裂的风险，高脂血症与 CA 破裂的风险降低相关。
