title: Effects of statin therapy on ascending aorta aneurysms growth: A propensity-matched analysis.
abstract: BACKGROUND
  Pleiotropic effects of statins have been advocated for remodeling of the vascular wall. The aim of the present study was to investigate whether statin therapy influences the growth rate of ascending aorta (AA) diameter.
  
  
  METHODS
  A total of 1348 patients was referred to our outpatient clinic for initial AA ectasia from September 2005 to December 2011. A propensity score was built to perfectly match (1:1) patients administered (Group A) or not (Group B) with statin therapy. Clinical and echocardiographic follow-up was 100% completed at 3 years after the first visit. Treatment groups were investigated for differences in AA maximum diameter, furthermore rates of survival free from death and/or complications were assessed by Kaplan-Meier analysis.
  
  
  RESULTS
  Finally, two fairly-comparable groups of 329 patients each were obtained (Propensity model c-statistic 0.86, p<0.0001). At baseline, mean AA diameters were 38.88 ± 2.48 mm and 39.09 ± 2.60 mm in Groups A and B, respectively. At 3-years, similar rates of hypertension control (86 ± 12% vs. 85 ± 14%) were found, whilst growth rate of AA diameter was +2.84 ± 1.33 mm (or +0.95 mm/year) in Group A and +3.80 ± 1.69 mm (or +1.27 mm/year) in Group B (p<0.0001). Three-year survival free from the composite outcome (death, dissection/rupture, need for operative repair) was found to be significantly improved in Group A (85.4 ± 2.0%) rather than in Group B (79.7 ± 2.2%), with a log-rank p=0.05 (HR 0.69, 95% CI 0.47 to 1.01).
  
  
  CONCLUSIONS
  In this study, statin treatment is associated with reduced growth rate of ascending aorta aneurysms. The latter resulted in improved survival free from complications for patients receiving statins.
authors.affiliation: Sapienza, University of Rome, Department of Cardiovascular Pathophysiology and Imaging, Italy; Eurytmia Medical Center, Anagni, Italy. Electronic address: emiliano.angeloni@uniroma1.it.
authors.forename: Emiliano
authors.initials: E
authors.lastname: Angeloni
authors.affiliation: Eurytmia Medical Center, Anagni, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Vitaterna
authors.affiliation: Eurytmia Medical Center, Anagni, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Pirelli
authors.affiliation: Sapienza, University of Rome, Department of Cardiovascular Pathophysiology and Imaging, Italy; Eurytmia Medical Center, Anagni, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Refice
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000517:prevention & control; D001011:Aorta / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000517:prevention & control; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000517:prevention & control; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Aortic aneurysms; Ascending aorta; Statins