Association of statins with aortic, peripheral, and visceral artery aneurysm development

Ishak A. Mansi, Chris Frei, Ethan A. Halm, Eric M. Mortensen

Research output: Contribution to journalArticle

Abstract

Objectives: Prior studies examining the effects of statins on arterial aneurysm development and progression yielded conflicting results due to their smaller size and presence of residual confounders. The objective of this study is to examine the association of statins with risk of being diagnosed with aortic, peripheral, and visceral artery aneurysm. Methods: This was a retrospective cohort study of Tricare enrollees (from 1 October 2003 to 31 March 2012). Main outcomes were diagnosis of aortic, peripheral, or visceral artery aneurysm and undergoing aortic aneurysm repair procedure during follow-up period. Using 115 baseline characteristics, we generated a propensity score to match statin users and nonusers and examine the odds of outcomes (primary analysis). Secondary analysis examined outcomes at various subcohorts. Results: Out of 10,910 statin users and 49,545 nonusers, we propensity score-matched 6728 pairs of statin users and nonusers. Statin users and nonusers had similar odds of being diagnosed with aortic, peripheral, and visceral artery aneurysms (odds ratio [OR]: 1.06, 95% confidence interval [95% CI]: 0.85–1.33) and of undergoing aortic aneurysm repair procedures (OR: 0.54, 95% CI: 0.22–1.35). Secondary analysis showed a tendency toward fewer aortic aneurysm procedures among statin users that did not reach statistical significance. However, high-intensity statin users in comparison to non-intensive statin users had higher adjusted odds of aortic, peripheral, and visceral artery aneurysms (OR: 1.76, 95% CI: 1.37–2.25, p <.0001). Conclusions: This study does not support a clinically significant benefit or harm from statins regarding development of arterial aneurysm. However, secondary analyses may support the hypothesis proposed by previous research proposing a bidirectional role for statins.

Original languageEnglish (US)
Pages (from-to)372-381
Number of pages10
JournalVascular
Volume25
Issue number4
DOIs
StatePublished - Aug 1 2017

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Aneurysm
Arteries
Aortic Aneurysm
Propensity Score
Odds Ratio
Confidence Intervals
Cohort Studies
Retrospective Studies

Keywords

  • Aortic aneurysm
  • arterial aneurysm
  • observational study
  • statins

ASJC Scopus subject areas

  • Surgery
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Association of statins with aortic, peripheral, and visceral artery aneurysm development. / Mansi, Ishak A.; Frei, Chris; Halm, Ethan A.; Mortensen, Eric M.

In: Vascular, Vol. 25, No. 4, 01.08.2017, p. 372-381.

Research output: Contribution to journalArticle

Mansi, Ishak A. ; Frei, Chris ; Halm, Ethan A. ; Mortensen, Eric M. / Association of statins with aortic, peripheral, and visceral artery aneurysm development. In: Vascular. 2017 ; Vol. 25, No. 4. pp. 372-381.
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AB - Objectives: Prior studies examining the effects of statins on arterial aneurysm development and progression yielded conflicting results due to their smaller size and presence of residual confounders. The objective of this study is to examine the association of statins with risk of being diagnosed with aortic, peripheral, and visceral artery aneurysm. Methods: This was a retrospective cohort study of Tricare enrollees (from 1 October 2003 to 31 March 2012). Main outcomes were diagnosis of aortic, peripheral, or visceral artery aneurysm and undergoing aortic aneurysm repair procedure during follow-up period. Using 115 baseline characteristics, we generated a propensity score to match statin users and nonusers and examine the odds of outcomes (primary analysis). Secondary analysis examined outcomes at various subcohorts. Results: Out of 10,910 statin users and 49,545 nonusers, we propensity score-matched 6728 pairs of statin users and nonusers. Statin users and nonusers had similar odds of being diagnosed with aortic, peripheral, and visceral artery aneurysms (odds ratio [OR]: 1.06, 95% confidence interval [95% CI]: 0.85–1.33) and of undergoing aortic aneurysm repair procedures (OR: 0.54, 95% CI: 0.22–1.35). Secondary analysis showed a tendency toward fewer aortic aneurysm procedures among statin users that did not reach statistical significance. However, high-intensity statin users in comparison to non-intensive statin users had higher adjusted odds of aortic, peripheral, and visceral artery aneurysms (OR: 1.76, 95% CI: 1.37–2.25, p <.0001). Conclusions: This study does not support a clinically significant benefit or harm from statins regarding development of arterial aneurysm. However, secondary analyses may support the hypothesis proposed by previous research proposing a bidirectional role for statins.

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