Clinical effectiveness of HMG-CoA reductase inhibitors on operated aortic aneurysm in Taiwan: a population based cohort study

Abstract

Aortic aneurysm is a leading cause of death in Asia and the world. However, there is limited data for aortic aneurysm using medication to control disease, especial in HMG-CoA reductase inhibitors. HMG-CoA reductase inhibitors are found to have anti-inflammatory and anti-proliferative mechanisms in aortic aneurysm . The aim of this study is to investigate the clinical outcomes of aortic aneurysm patients who received operation taking HMG-CoA reductase inhibitors. We conducted a population-based cohort study. We identified patients who having diagnosis of aortic aneurysm and also receiving operation between January 1, 2005 and December 31, 2010. We divided study population into HMG-CoA reductase inhibitors users and non- HMG-CoA reductase inhibitors group. The endpoints included all-cause death, AA-related re-hospitalization and re-operation. The association between HMG-CoA reductase inhibitors use and outcome for patients received operation was evaluated by cox regression. We included 1936 operated AA patients during 2005-2010, 1633 of them survived more than 30 days. Among the 1633 patients, we found that both of HMG-CoA reductase inhibitors significantly decrease the all-cause mortality HMG-CoA reductase inhibitors: HR:0.279, CI:0.175-0.444). However, HMG-CoA reductase inhibitors exposure did not decrease AA-related re-hospitalization and re-operation. In conclusion, prescribing HMG-CoA reductase inhibitors after AA surgery could decrease the all-cause mortality significantly, but was no significant benefit for re-operation and re-hospitalization.