Effects of Statin Therapy on Abdominal Aortic Aneurysm Growth: A Meta-analysis and Meta-regression of Observational Comparative Studies

Takagi H, Yamamoto H, Iwata K, et al (Shizuoka Med Ctr, Japan) Eur J Vasc Endovasc Surg 44:287-292, 2012^§

Abstract

Objective

To determine whether statin therapy reduces the growth rate of small abdominal aortic aneurysms (AAAs).

Design

A meta-analysis and a meta-regression of comparative studies.

Materials

Eligible studies were randomized controlled trials or observational comparative studies of statin therapy versus placebo or no statin, enrolling individuals with small (<55 mm in diameter) AAAs and reporting AAA growth rate as an outcome.

Methods

Study-specific estimates (standardized mean differences [SMDs]) were combined in the fixed- and random-effects model.

Results

Seven adjusted and 4 unadjusted observational comparative studies enrolling 4647 patients with a small AAA were identified. Pooled analysis of all 11 studies suggested a significant reduction in AAA growth rate among patients assigned to statin therapy versus no statin (SMD, −0.420; 95% confidence interval [CI], −0.651 to −0.189). Combining the 7 high-quality studies providing adjusted data for growth rates generated an attenuated but still statistically significant result favoring statin therapy (SMD, −0.367; 95% CI, −0.566 to −0.168). The meta-regression coefficient for the baseline diameter was statistically significant (−0.096; 95% CI, −0.132 to −0.061).

Conclusion

Statin therapy is likely effective in prevention of the growth of small AAAs, and may be more beneficial as the baseline diameter increases (Fig 3).

Figure 3 Forest plot of growth rates of abdominal aortic aneurysm among patients assigned to statin therapy versus no statins from the 7 high-quality studies providing adjusted data. (Reprinted from European Journal of Vascular and Endovascular Surgery. Takagi H, Yamamoto H, Iwata K, et al. Effects of statin therapy on abdominal aortic aneurysm growth: a meta-analysis and meta-regression of observational comparative studies. Eur J Vasc Endovasc Surg. 2012;44:287-292, Copyright 2012, with permission from European Society for Vascular Surgery.)

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