THERE IS AN EFFECTIVE MEDICAL TREATMENT FOR THORACIC AORTIC ANEURYSM


John A. Elefteriades, M.D., Yale University School of Medicine, New Haven, CT, USA

Objective: The potential of medical therapy to influence the courses and outcomes of patients with thoracic aortic aneurysms is not known. The aim of this study was to determine whetherstatin intake is associated with improved long-term outcomes in these patients.

Methods and Results: A total of 649 patients with thoracic aortic aneurysms were studied, of whom 147 were taking statins at their first presentation and 502 were not. After a median follow-up period of 3.6 years,30 patients (20%) taking statins had died, compared with 167 patients (33%) not takingstatins (hazard ratio 0.68, 95% confidence interval 0.46 to 1, p _ 0.049); 87 patients (59%) taking statins reached the composite end point of death, rupture, dissection, or repaircompared with 378 patients (75%) not taking statins (hazard ratio 0.72, 95% confidenceinterval 0.57 to 0.91, p _ 0.006). After adjustments for co-morbidities, the associationbetween statin therapy and the composite end point was driven mainly by a reduction inaneurysm repairs (hazard ratio 0.57 95% confidence interval 0.4 to 0.83, p _ 0.003). OnKaplan-Meier analysis, the survival rate of patients taking statins was significantly better(p _ 0.047).

Conclusion: In conclusion, the intake of stains was associated with an improvement inlong-term outcomes in this cohort of patients with thoracic aortic aneurysms. This wasdriven mainly by a reduction in aneurysm repairs.