Does Statin Use Affect Survival After a Ruptured Abdominal Aortic Aneurysm?
Does Statin Use Affect Survival After a Ruptured Abdominal Aortic Aneurysm?
Feeney JM, Burns K, Staff I, et al
J Am Coll Surg. 2009;209:41-46
The aim of this study was to compare survival after the rupture of an abdominal aortic aneurysm in 81 patients who either used (n = 23) or did not use (n = 58) 3-hydroxy-3-methyl-glutaryl coenzyme A reductase inhibitors (statins) in the period before the rupture. The two groups were similar with respect to age and sex, but the presence of preoperative risk factors as determined by the Physiologic and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) was somewhat lower in the statin group (mean score, 35.7 vs 39.5; P = .10). Mortality in the statin users was 34.8% compared with 63.8% in the nonusers (P = .018). There was no significant difference in the use of endostents.
Previous reports suggest that statins may reduce inflammatory mediators, perhaps explaining why statins appear to protect against septic shock. However, as suggested by the investigators, another explanation for the striking mortality reduction reported in this study is simply that compared with nonstatin users, statin users received better long-term healthcare and were somewhat healthier than nonstatin users. The observed difference in preoperative risk factors, although not statistically significant, is compatible with this explanation.
Abstract
Prehospital HMG Co-A Reductase Inhibitor Use and Reduced Mortality in Ruptured Abdominal Aortic Aneurysm
Feeney JM, Burns K, Staff I, et al
J Am Coll Surg. 2009;209:41-46
Summary
The aim of this study was to compare survival after the rupture of an abdominal aortic aneurysm in 81 patients who either used (n = 23) or did not use (n = 58) 3-hydroxy-3-methyl-glutaryl coenzyme A reductase inhibitors (statins) in the period before the rupture. The two groups were similar with respect to age and sex, but the presence of preoperative risk factors as determined by the Physiologic and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) was somewhat lower in the statin group (mean score, 35.7 vs 39.5; P = .10). Mortality in the statin users was 34.8% compared with 63.8% in the nonusers (P = .018). There was no significant difference in the use of endostents.
Viewpoint
Previous reports suggest that statins may reduce inflammatory mediators, perhaps explaining why statins appear to protect against septic shock. However, as suggested by the investigators, another explanation for the striking mortality reduction reported in this study is simply that compared with nonstatin users, statin users received better long-term healthcare and were somewhat healthier than nonstatin users. The observed difference in preoperative risk factors, although not statistically significant, is compatible with this explanation.
Abstract
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