Effect of lipid-modifying therapy on long-term mortality after abdominal aortic aneurysm repair: a systemic review and meta-analysis.
BACKGROUND
Several observational studies have demonstrated that lipid-modifying therapy may improve long-term survival in abdominal aortic aneurysm (AAA) patients after repair. We carried out a systematic review and meta-analysis of studies evaluating the effect of lipid-modifying therapy on long-term mortality.


METHODS
We conducted a systematic search of multiple databases up to April 2014. Studies that evaluated exposure to lipid-modifying therapy, reported mortality data and hazard ratio (HR) or provided survival curve for their estimation were included in the meta-analysis. Pooled HR estimates with 95% confidence intervals (CIs) were calculated using the random-effects model.


RESULTS
Eight studies (seven cohorts, one post hoc study of a randomization controlled trial) reporting 2,605 patients on lipid-modifying therapy were included. Meta-analysis showed a significant 39% reduction in long-term mortality with lipid-modifying therapy (HR 0.61; 95% CI 0.51-0.73). After exclusion of one study which was contributing to considerable heterogeneity, a significant 33% reduction in mortality risk was a more conservative, consistent estimate (HR 0.67; 95% CI 0.59-0.77).


CONCLUSIONS
Meta-analysis of studies supports a protective role of lipid-modifying therapy on mortality risk after AAA repair. Aggressive lipid intervention should be recommended to those who receiving AAA repair.
Department of Vascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, People's Republic of China.
Wenwen
W
Zhang
Zhao
Z
Liu
Changjian
C
Liu
D017544:Aortic Aneurysm, Abdominal / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors