Due to the limited number of included trials , there is insufficient evidence to draw any conclusions about the effectiveness of cardiovascular prophylaxis in reducing mortality and cardiovascular events in people with AAA .
BACKGROUND Pharmacological prophylaxis has been proven to reduce the risk of cardiovascular events in individuals with atherosclerotic occlusive arterial disease .
However , the role of prophylaxis in individuals with abdominal aortic aneurysm ( AAA ) remains unclear .
Several studies have shown that despite successful repair , those people with AAA have a poorer rate of survival than healthy controls .
People with AAA have an increased prevalence of coronary heart disease and risk of cardiovascular events .
Despite this association , little is known about the effectiveness of pharmacological prophylaxis in reducing cardiovascular risk in people with AAA .
This is an up date of a Cochrane review first published in 2014 .
OBJECTIVES To determine the long-term effectiveness of antiplatelet , antihypertensive or lipid-lowering medication in reducing mortality and cardiovascular events in people with abdominal aortic aneurysm ( AAA ) .
Statin therapy is associated with improved survival after endovascular and open aneurysm repair.
BACKGROUND The relationship between numerous risk factors and perioperative mortality after cardiovascular surgery has been studied extensively . While improved perioperative survival and fewer cardiovascular events have been related to statin therapy , its effect on long-term survival after aneurysm repair remains to be eluci date d. The aim of this study is to determine the effect of statin therapy on long-term survival after open and endovascular aneurysm repair and to identify other cardiovascular and patient-related risk factors in this respect . METHODS A post-hoc analysis of a r and omized trial comparing open and endovascular abdominal aortic aneurysm repair was performed . In this multicenter trial , 351 patients were r and omly assigned to undergo either open abdominal aortic aneurysm repair or endovascular repair . Patients who were on lipid-lowering medication at their inclusion in the trial ( n = 135 ) were compared with those who were not ( n = 216 ) . RESULTS During 6 years of follow-up , 118 ( 33.6 % ) patients died after r and omization . Statin therapy , baseline characteristics , Society for Vascular Surgery/International Society for Cardiovascular Surgery risk factors , aneurysm size , re interventions , antiplatelet or anticoagulant agents , and β-blockers were used to identify prognostic factors influencing survival . After identification of significant factors in a Kaplan-Meier analysis , a multivariable Cox regression analysis was applied . Statin therapy at inclusion in the trial was independently associated with better overall survival after open or endovascular aneurysm repair ( hazard ratio [ HR ] , 0.5 ; 95 % confidence interval [ CI ] , 0.3 - 0.8 ; P = .004 ) . Statins were especially associated with fewer cardiovascular deaths ( HR , 0.4 ; 95 % CI , 0.2 - 0.9 ; P = .025 ) . Several risk factors were associated with poor survival after open and endovascular aneurysm repair : age > 70 ( HR , 3.4 ; 95 % CI , 2.2 - 5.0 ; P < .001 ) , a history of cardiac disease at baseline ( HR , 1.9 ; 95 % CI , 1.3 - 2.8 ; P = .001 ) , and moderate/severe tobacco use ( HR , 1.7 ; 95 % CI , 1.2 - 2.5 ; P = .004 ) . Gender , aneurysm size , the need for reintervention , pulmonary disease , renal disease , carotid disease , hypertension , diabetes mellitus , antiplatelet or anticoagulant agents , and β-blockers were not significantly associated with impaired long-term survival ( P > .05 ) . CONCLUSIONS Despite the limitations of a post-hoc analysis of a prospect ively maintained trial , we conclude that statin therapy at the beginning of the trial is independently associated with improved long-term survival after open or endovascular aneurysm repair , while age above 70 years , a history of cardiovascular disease , and tobacco use are associated with decreased long-term survival
Due to the limited number of included trials , there is insufficient evidence to draw any conclusions about the effectiveness of cardiovascular prophylaxis in reducing mortality and cardiovascular events in people with AAA .
BACKGROUND Pharmacological prophylaxis has been proven to reduce the risk of cardiovascular events in individuals with atherosclerotic occlusive arterial disease .
However , the role of prophylaxis in individuals with abdominal aortic aneurysm ( AAA ) remains unclear .
Several studies have shown that despite successful repair , those people with AAA have a poorer rate of survival than healthy controls .
People with AAA have an increased prevalence of coronary heart disease and risk of cardiovascular events .
Despite this association , little is known about the effectiveness of pharmacological prophylaxis in reducing cardiovascular risk in people with AAA .
This is an up date of a Cochrane review first published in 2014 .
OBJECTIVES To determine the long-term effectiveness of antiplatelet , antihypertensive or lipid-lowering medication in reducing mortality and cardiovascular events in people with abdominal aortic aneurysm ( AAA ) .