Association of statin prescription with small abdominal aortic aneurysm progression.
Association of statin prescription with small abdominal aortic aneurysm progression.
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DOI：
10.1016/j.ahj.2009.11.016
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发表时间：
2010-02
影响因子：
4.8
通讯作者：
Golledge, Jonathan
中科院分区：
文献类型：
--
作者：
Ferguson, Craig D.;Clancy, Paula;Bourke, Bernard;Walker, Philip J.;Dear, Anthony;Buckenham, Tim;Norman, Paul;Golledge, Jonathan
他汀类药物已被建议用于减少腹主动脉瘤(AAA)的扩张，而不依赖于降脂作用。我们评估了他汀类药物治疗和血清低密度脂蛋白(LDL)浓度与AAA小幅扩张的关系。来自五个血管中心的652名接受小型AAA监测的患者进入研究。在一个子集中，测量了空腹血脂(n=451)和其他生物标志物(n=216)。对腹主动脉直径进行超声监测，中位数为5年。349例(54%)患者服用了他汀类药物。调整其他危险因素后，他汀类药物处方与AAA增长无关(优势比，OR，1.23，95%可信区间，CI，0.86-1.76)。腹主动脉中位数以上的增长与初始内径呈正相关(OR1.78/4.35 mm，95%CI为1.49~2.14)，与糖尿病呈负相关(OR 0.37，95%CI为0.22~0.62)。血清低密度脂蛋白浓度高于中位数与腹主动脉瘤的增长无关。与未服用他汀类药物的患者相比，服用他汀类药物的患者血清C-反应蛋白浓度较低，但基质金属蛋白酶-9和白细胞介素6浓度相似。我们发现他汀类药物处方或低密度脂蛋白浓度与AAA扩大无关。这一结果并不支持较小规模研究的结果，并表明他汀类药物在减少AAA进展方面可能没有好处。
Statins have been suggested to reduce expansion of abdominal aortic aneurysms (AAA) independent of lipid lowering effects. We assessed the association of statin treatment and serum low density lipoprotein (LDL) concentrations with small AAA expansion. 652 patients undergoing surveillance of small AAAs were entered into the study from five vascular centers. In a subset fasting lipids (n=451) and other biomarkers (n=216) were measured. AAA diameter was followed by ultrasound surveillance for a median of 5 years. 349 (54%) of the patients were prescribed statins. Adjusting for other risk factors statin prescription was not associated with AAA growth (odds ratio, OR, 1.23, 95% confidence interval, CI, 0.86–1.76). Above median AAA growth was positively associated with initial diameter (OR 1.78 per 4.35mm larger initial aortic diameter, 95% CI 1.49–2.14) and negatively associated with diabetes (OR 0.37, 95% CI 0.22–0.62). Above median serum LDL concentration was not associated with AAA growth. Patients receiving statins had lower serum C-reactive protein concentrations but similar matrix metalloproteinase-9 and interleukin-6 concentrations to those not prescribed these medications. We found no association between statin prescription or LDL concentration with AAA expansion. The results do not support the findings of smaller studies and suggest that statins may have no benefit in reducing AAA progression.
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