Erschienen in:
01.03.2015 | Scientific Review
Effect of Lipid-Modifying Therapy on Long-Term Mortality After Abdominal Aortic Aneurysm Repair: A Systemic Review and Meta-Analysis
verfasst von:
Wenwen Zhang, Zhao Liu, Changjian Liu
Erschienen in:
World Journal of Surgery
|
Ausgabe 3/2015
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Abstract
Background
Several observational studies have demonstrated that lipid-modifying therapy may improve long-term survival in abdominal aortic aneurysm (AAA) patients after repair. We carried out a systematic review and meta-analysis of studies evaluating the effect of lipid-modifying therapy on long-term mortality.
Patients and methods
We conducted a systematic search of multiple databases up to April 2014. Studies that evaluated exposure to lipid-modifying therapy, reported mortality data and hazard ratio (HR) or provided survival curve for their estimation were included in the meta-analysis. Pooled HR estimates with 95 % confidence intervals (CIs) were calculated using the random-effects model.
Results
Eight studies (seven cohorts, one post hoc study of a randomization controlled trial) reporting 2,605 patients on lipid-modifying therapy were included. Meta-analysis showed a significant 39 % reduction in long-term mortality with lipid-modifying therapy (HR 0.61; 95 % CI 0.51–0.73). After exclusion of one study which was contributing to considerable heterogeneity, a significant 33 % reduction in mortality risk was a more conservative, consistent estimate (HR 0.67; 95 % CI 0.59–0.77).
Conclusion
Meta-analysis of studies supports a protective role of lipid-modifying therapy on mortality risk after AAA repair. Aggressive lipid intervention should be recommended to those who receiving AAA repair.