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 ) .
Fluvastatin and perioperative events in patients undergoing vascular surgery.
BACKGROUND Adverse cardiac events are common after vascular surgery . We hypothesized that perioperative statin therapy would improve postoperative outcomes . METHODS In this double-blind , placebo-controlled trial , we r and omly assigned patients who had not previously been treated with a statin  to receive , in addition to a beta-blocker , either 80 mg of extended-release fluvastatin or placebo once daily before undergoing vascular surgery .  Lipid , interleukin-6 , and C-reactive protein levels were measured at the time of r and omization and before surgery . The primary end point was the occurrence of myocardial ischemia , defined as transient electrocardiographic abnormalities , release of troponin T , or both , within 30 days after surgery . The secondary end point was the composite of death from cardiovascular causes and myocardial infa rct ion . RESULTS A total of 250 patients were assigned to fluvastatin  , and 247 to placebo , a median of 37 days before vascular surgery . Levels of total cholesterol , low-density lipoprotein cholesterol , interleukin-6 , and C-reactive protein were significantly decreased in the fluvastatin group but were unchanged in the placebo group . Postoperative myocardial ischemia occurred in 27 patients ( 10.8 % ) in the fluvastatin group and in 47 ( 19.0 % ) in the placebo group ( hazard ratio , 0.55 ; 95 % confidence interval [ CI ] , 0.34 to 0.88 ; P=0.01 ) . Death from cardiovascular causes or myocardial infa rct ion occurred in 12 patients ( 4.8 % ) in the fluvastatin group and 25 patients ( 10.1 % ) in the placebo group ( hazard ratio , 0.47 ; 95 % CI , 0.24 to 0.94 ; P=0.03 ) . Fluvastatin therapy was not associated with a significant increase in the rate of adverse events . CONCLUSIONS In patients undergoing vascular surgery , perioperative fluvastatin therapy was associated with an improvement in postoperative cardiac outcome . ( Current Controlled Trials number , IS RCT N83738615 .
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 ) .