Objective: Cardiac and cerebrovascular complications are major causes of morbidity and mortality following thoracic endovascular aortic repair (TEVAR). The benefits of statins have been established, but little is known about their impact on patients undergoing TEVAR. We investigated whether chronic statin use protected against early postoperative major adverse cardiac and cerebrovascular events (MACCEs) after TEVAR.

Methods: We retrospectively reviewed 211 patients who underwent TEVAR between February 2013 and March 2017 classified into two groups, those with acute aortic syndrome (AAS, n = 79) and those without (non-AAS, n = 132). Patients were subdivided according to preoperative statin therapy for ≥3 months or not. The primary endpoint was 30-day MACCE, defined as new myocardial infarction, stroke, arrhythmia, cardiovascular death, or cerebrovascular death. Acute kidney injury (AKI) occurrence within 48 hours after TEVAR was also evaluated. Multivariate logistic regression analysis was performed to identify independent risk factors for adverse outcomes such as MACCEs and AKI.

Results: Incidence of stroke (0% vs. 7%, p = 0.026) and MACCEs (1% vs. 13%, p = 0.008) was significantly lower in the statin group than in the no-statin group in non-AAS patients, whereas in AAS patients, these values were comparable between groups. Multivariate logistic regression analysis revealed statin use (odds ratio 0.52, 95% confidence interval 0.10-0.62, p = 0.019) and chronic kidney disease (odds ratio 9.82, 95% confidence interval 1.29-75.00, p = 0.028) as independent predictors for MACCE in non-AAS patients. The AKI incidence was significantly higher in the statin group than in the no-statin group in AAS patients (44% vs. 15%, p = 0.018), whereas it was comparable in non-AAS patients.

Conclusions: In patients undergoing TEVAR, chronic statin use may protect against 30-day MACCEs in non-AAS patients, but not in AAS patients. It might be rather associated with increased risk of AKI in AAS patients, which warrants further study. 


04 / Effects of Chronic Statin Use on 30-day Major Adverse Cardiac and Cerebrovascular Events after Thoracic Endovascular Aortic Repair