title: Association of statins with aortic, peripheral, and visceral artery aneurysm development.
abstract: Objectives Prior studies examining the effects of statins on arterial aneurysm development and progression yielded conflicting results due to their smaller size and presence of residual confounders. The objective of this study is to examine the association of statins with risk of being diagnosed with aortic, peripheral, and visceral artery aneurysm. Methods This was a retrospective cohort study of Tricare enrollees (from 1 October 2003 to 31 March 2012). Main outcomes were diagnosis of aortic, peripheral, or visceral artery aneurysm and undergoing aortic aneurysm repair procedure during follow-up period. Using 115 baseline characteristics, we generated a propensity score to match statin users and nonusers and examine the odds of outcomes (primary analysis). Secondary analysis examined outcomes at various subcohorts. Results Out of 10,910 statin users and 49,545 nonusers, we propensity score-matched 6728 pairs of statin users and nonusers. Statin users and nonusers had similar odds of being diagnosed with aortic, peripheral, and visceral artery aneurysms (odds ratio [OR]: 1.06, 95% confidence interval [95% CI]: 0.85-1.33) and of undergoing aortic aneurysm repair procedures (OR: 0.54, 95% CI: 0.22-1.35). Secondary analysis showed a tendency toward fewer aortic aneurysm procedures among statin users that did not reach statistical significance. However, high-intensity statin users in comparison to non-intensive statin users had higher adjusted odds of aortic, peripheral, and visceral artery aneurysms (OR: 1.76, 95% CI: 1.37-2.25, p < .0001). Conclusions This study does not support a clinically significant benefit or harm from statins regarding development of arterial aneurysm. However, secondary analyses may support the hypothesis proposed by previous research proposing a bidirectional role for statins.
authors.affiliation: 1 Department of Medicine, VA North Texas Health Care System, Dallas, TX, USA.|2 Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.|3 Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Ishak A
authors.initials: IA
authors.lastname: Mansi
authors.affiliation: 4 College of Pharmacy, The University of Texas at Austin, San Antonio, TX, USA.|5 Department of Medicine, School of Medicine, University of Texas Health Science Center, San Antonio, TX, USA.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Frei
authors.affiliation: 2 Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.|3 Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Ethan A
authors.initials: EA
authors.lastname: Halm
authors.affiliation: 1 Department of Medicine, VA North Texas Health Care System, Dallas, TX, USA.|2 Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.|3 Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Mortensen
mesh_terms: D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D057216:Propensity Score; D065840:Protective Factors; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology; D013997:Time Factors; D014781:Viscera / Q000098:blood supply*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Aortic aneurysm; arterial aneurysm; observational study; statins