Background: In the era of Abdominal Aortic Aneurysm (AAA) screening, pharmacotherapies to attenuate
AAA growth are sought. HMG Co-A reductase inhibitors (statins) have pleiotropic actions independent of their lipid lowering
effects and have been suggested as potential treatment for small AAAs. We systematically review the clinical evidence
for this effect. Methods: Medline, EMBASE and the Cochrane Central Register of Controlled Trials (1950-2011)
were searched for studies reporting data on the role of statin therapy on AAA growth rate. No language restrictions were
placed on the search. References of retrieved articles and pertinent journals were hand searched. Included studies were reviewed
by 2 independent observers. The search retrieved 164 papers, 100 were irrelevant based on their title, 47 were reviews
and 1 was a letter. 8 studies were excluded based on review of their abstract leaving 8 for inclusion in the study.
Results: Eight observational clinical studies with a total of 4,466 patients were reviewed. Four studies demonstrated reduced
AAA expansion in statin users while 4 studies failed to demonstrate this effect. The method of determining AAA
growth rates varied significantly between the studies and the ability of many studies to control for misclassification bias
was poor. Conclusions: The claim that statins attenuate AAA growth remains questionable. Further prospective studies
with stringent identification and verification of statin usage and a standardised method of estimating AAA growth rates
are required. Statin type and dose also merit consideration.
Keywords: Abdominal aortic aneurysm, aneurysm, expansion, growth, statin.
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