Effect of Statin Therapy on Survival After Abdominal Aortic Aneurysm Repair: A Systematic Review and Meta-analysis.

Abstract

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, I² = 70.1%), short-term mortality (RR 0.60, 95% CI 0.38-0.98, I² = 51.7%), and fewer perioperative cardiac complications (RR 0.46, 95% CI 0.26-0.80, I² = 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.