Effect of Lipid-Modifying Therapy on Long-Term Mortality After Abdominal Aortic Aneurysm Repair: A Systemic Review and Meta-Analysis

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.