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.

Keywords: Aortic aneurysms; Ascending aorta; Statins.