Relationships of Statins Therapy and Hyperlipidemia with the Incidence, Rupture, Post-repair Mortality and All-cause Mortality of Abdominal Aortic Aneurysm and Cerebral Aneurysm: A Meta-analysis and Systematic Review.

Statins have been suggested in previous studies to play a protective role in experimental cerebral aneurysm (CA) models; however, no evidence supports that the application of statins can protect against aneurysm rupture in humans, and the risks of lipid levels and aneurysms remain unknown. Therefore, this meta-analysis aimed to summarize and update the epidemiological evidence to systematically assess the relationships of statins therapy and hyperlipidemia with the incidence, rupture, post-repair mortality and all-cause mortality of abdominal aortic aneurysm (AAA) and CA. Related studies were initially retrieved from the electronic databases PubMed, Embase and Cochrane library from inception to August 4, 2018. Subsequently, 33 studies were enrolled into this meta-analysis, and the maximum adjusted relative ratios (RRs) as well as the corresponding 95% confidence intervals (CIs) were extracted. Finally, a total of 32 observational studies involving 150,134 participants were enrolled into this meta-analysis The RRs of statins therapy for AAA incidence, AAA rupture, CA rupture, post-repair mortality, all-cause mortality and adverse events (AEs) were 1.83 (0.56-5.98), 0.67 (0.47-0.97), 0.50 (0.18-1.36), 0.60 (0.48-0.74), 0.66 (0.58-0.75), and 0.58 (0.47-0.71), respectively. Besides, the RR of hyperlipidemia for CA rupture was 0.79 (0.67-0.93). Our findings suggested that statins therapy could reduce the risks of AAA rupture, post-repair mortality, all-cause mortality and AEs, without inducing the risk of AAA incidence or CA rupture, and that hyperlipidemia was associated with a lower risk of CA rupture.