Key result
Lipid-modifying therapy was associated with a significant 39% reduction in long-term mortality after abdominal aortic aneurysm repair (HR 0.61; 95% CI 0.51-0.73).
Why the study?
Does lipid-modifying therapy reduce long-term mortality in patients after abdominal aortic aneurysm repair?
Meta-Analysis (n=2,605)
Does lipid-modifying therapy reduce long-term mortality in patients after abdominal aortic aneurysm repair?
Hazard Ratio: 0.61 (95% CI 0.51–0.73)
Lipid-modifying therapy is associated with a significant reduction in long-term mortality after abdominal aortic aneurysm repair, supporting aggressive lipid intervention in this population.
Supports lipid-modifying therapy after AAA repair; extends observational evidence but leaves open need for RCTs.
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. PATIENTS AND 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). CONCLUSION: 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.
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Zhang et al. (2014) conducted a meta-analysis in Abdominal aortic aneurysm (AAA) after repair (n=2,605). Lipid-modifying therapy vs. No lipid-modifying therapy was evaluated on Long-term mortality (HR 0.61, 95% CI 0.51-0.73). Lipid-modifying therapy was associated with a significant 39% reduction in long-term mortality after abdominal aortic aneurysm repair (HR 0.61; 95% CI 0.51-0.73).
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