Comparison of the Effect on Long-Term Outcomes in Patients With Thoracic Aortic Aneurysms of Taking Versus Not Taking a Statin Drug
Comparison of the Effect on Long-Term Outcomes in Patients With Thoracic Aortic Aneurysms of Taking Versus Not Taking a Statin Drug
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DOI：
10.1016/j.amjcard.2011.11.038
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发表时间：
2012-04-01
影响因子：
2.8
通讯作者：
Elefteriades, John A.
中科院分区：
文献类型：
--
作者：
Jovin, Ion S.;Duggal, Mona;Elefteriades, John A.
药物治疗对胸主动脉瘤患者病程和结果的影响尚不清楚。本研究的目的是确定他汀类药物的摄入是否与这些患者的长期预后改善相关。总共有 649 名胸主动脉瘤患者接受了研究，其中 147 名患者首次就诊时正在服用他汀类药物，502 名则没有服用。中位随访期为 3.6 年后，服用他汀类药物的患者有 30 名 (20%) 死亡，而未服用他汀类药物的患者有 167 名 (33%) 死亡（风险比 0.68，95% 置信区间 0.46 至 1，p = 0.049）；服用他汀类药物的 87 名患者 (59%) 达到了死亡、破裂、夹层或修复的复合终点，而未服用他汀类药物的患者为 378 名 (75%)（风险比 0.72，95% 置信区间 0.57 至 0.91，p = 0.006）。对合并症进行调整后，他汀类药物治疗与复合终点之间的关联主要是由动脉瘤修复的减少驱动的（风险比 0.57，95% 置信区间 0.4 至 0.83，p = 0.003）。根据 Kaplan-Meier 分析，服用他汀类药物的患者的生存率明显更高 (p = 0.047)。总之，染色剂的摄入与这组胸主动脉瘤患者的长期预后改善相关。这主要是由于动脉瘤修复的减少所致。 (C) 2012 Elsevier Inc. 保留所有权利。 (Am J Cardiol 2012；109:1050-1054)
The potential of medical therapy to influence the courses and outcomes of patients with thoracic aortic aneurysms is not known. The aim of this study was to determine whether statin intake is associated with improved long-term outcomes in these patients. A total of 649 patients with thoracic aortic aneurysms were studied, of whom 147 were taking statins at their first presentation and 502 were not. After a median follow-up period of 3.6 years, 30 patients (20%) taking statins had died, compared with 167 patients (33%) not taking statins (hazard ratio 0.68, 95% confidence interval 0.46 to 1, p = 0.049); 87 patients (59%) taking statins reached the composite end point of death, rupture, dissection, or repair compared with 378 patients (75%) not taking statins (hazard ratio 0.72, 95% confidence interval 0.57 to 0.91, p = 0.006). After adjustments for co-morbidities, the association between statin therapy and the composite end point was driven mainly by a reduction in aneurysm repairs (hazard ratio 0.57 95% confidence interval 0.4 to 0.83, p = 0.003). On Kaplan-Meier analysis, the survival rate of patients taking statins was significantly better (p = 0.047). In conclusion, the intake of stains was associated with an improvement in long-term outcomes in this cohort of patients with thoracic aortic aneurysms. This was driven mainly by a reduction in aneurysm repairs. (C) 2012 Elsevier Inc. All rights reserved. (Am J Cardiol 2012;109:1050-1054)