Abstract 18525: Effects of Statin Therapy on Ascending Aorta Aneurysms Growth: a Propensity-matched Analysis of 828 Patients

Abstract

Introduction: Pleiotropic effects of statins have been advocated for remodelling of the vascular wall. Hypothesis: Whether statin therapy influences the growth rate of ascending aorta (AA) aneurysms. Methods: A total of 1348 patients was referred to our outpatient clinic for initial AA ectasia from September 2005 to December 2010. 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-Meyer analysis. Results: Finally, two fairly-comparable groups of 414 patients each were obtained (Propensity model c-statistic 0.84, p<0.0001). No significant differences were noted in baseline characteristics, mean AA diameters were 40.9±2.6 mm and 40.7±2.5 mm in Group A and B, respectively. At 3-years, similar rates of hypertension control (84±9% vs. 83±11%) were found, whilst growth rate of AA diameter was +22.3±9.4 mm in Group A (+7.4 mm/year) and +26.5±8.4 mm (+8.8 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 (64±4%) rather than in Group B (53±5%), with a log-rank p=0.002 (HR 0.41, 95%CI 0.37 to 0.48). Conclusions: In this study, statin treatment is associated with reduced growth rate of ascending aorta aneurysms. The latter resulted in better survival free from complications for patients receiving statins.