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Cardiology |
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| 15 Oct 2009 | Viewed: 36 | |
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Patients taking cholesterol-lowering statin drugs may have better
results and lower procedure costs when having a common operation for
repairing a bulging aorta, according to a new study presented at the
95th annual Clinical Congress of the American College of Surgeons.
"We think that anyone with a diagnosis of abdominal aortic aneurysm
would signifi-cantly benefit from being on a statin before the
operation," reported Michael Morgan McNally, MD, study coauthor from
the East Carolina Heart Insitute of the Brody School of Medicine, East
Carolina University in Greenville, NC.
Abdominal aortic aneurysm (AAA) is the medical term for an aorta that
widens to three inches or more in diameter and three to four times its
normal diameter, causing risk of rupture. The largest blood vessel in
the body, the aorta connects the heart to branch arteries throughout
the body.
Approximately five percent of men over age 60 will develop AAA, according to the American Heart Association.
Dr. McNally and his colleagues investigated 401 cases of AAA repair
surgery at their institution. Regardless of what type of procedure
patients had--whether the traditional open repair or the endovascular
approach, in which the repair is done from inside the aorta--statin
users typically had fewer complications and a lower chance of
postoperative death. This result held true even though the statin users
had more concurrent health problems than the control subjects did.
None of the statin patients in the study died after the AAA repair
procedure, whereas five percent of those not taking statins died after
the operation. "The study findings point to the powerful risk reduction
ascribed to statins and highlights the importance of giving these drugs
to patients undergoing cardiovascular procedures," Dr. McNally said.
"These patients should get on statin therapy as early as possible, but
our study saw a significant benefit even after only 30 days on a
statin," he said.
The investigators also determined that the total costs for AAA repair
was lower for statin patients, again regardless of what procedure they
underwent. The endovascular approach cost on average $33,237 per
patient on statin drugs versus $36,442 in control patients; the open
approach cost $18,647 per statin patient compared with $22,440 in the
control group. "The study focuses on the financial impact of this
approach and the importance of this for the health care system," Dr.
McNally said.
"The bottom line is that risk optimization in the workup of any patient
having AAA repair is imperative," Dr. McNally added. "The workup would
include looking at their medications and what they've been on
preoperatively."
The next step is for the researchers to examine the individual clinical
outcomes behind the cost savings, and to investigate the potentially
protective properties of other commonly prescribed cardiovascular
medications, including beta blockers and angiotensin-converting enzyme
inhibitors. Furthermore, these data demonstrate the importance of
examining the role of preoperative risk optimization in registries,
databases, and future prospective studies, said Dr. McNally.
In addition to Dr. McNally, Steven C. Agle, MD, MPH; Samuel A. Hayes,
BS; Frank M. Parker, DO, FACS; William M. Bogey, MD, FACS; Charles S.
Powell, MD, FACS; and Michael C. Stoner, MD, FACS, participated in the
study.
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| News Source: medical news today |
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