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Suppressive effect of pitavastatin on aortic arch dilatation in acute stanford type B aortic dissection: analysis of STANP trial

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Abstract

Objectives

Medical therapy for patients with uncomplicated acute type B aortic dissection (ABAD) is essentially accepted for its excellent early outcome; however, long-term outcomes have not been satisfactory due to aorta-related complications. This trial was performed to investigate the efficacy of a statin as an additive that may enhance the effectiveness of conventional medical treatment in patients with ABAD.

Methods

This was a multi-center, prospective, and randomized comparative investigation of patients with uncomplicated ABAD. Fifty patients with ABAD compatible with inclusion criteria were randomly assigned to two groups and then received administration of pitavastatin (group P) or not (group C). We followed up the patients for 1 year from study onset.

Results

Two patients demised during the follow-up period (both were in group C). In addition, aorta-related interventions were performed in two patients (entry closure for aortic dissection by endovascular repair in one patient in each group). Aortic arch diameters at 1 year in group P tended to be smaller than in group C (P = 0.17), and the rate of change of the aortic arch diameters from onset to 1 year was significantly lower in group P (P = 0.046). Multivariate analysis identified patency of the false lumen was detected as a risk factor for aortic arch dilatation (P = 0.02), and pitavastatin intake was a negative risk factor (P = 0.03).

Conclusions

Pitavastatin treatment, in addition to the standard antihypertensive therapy, may have a suppressive effect on aortic arch dilatation in patients with ABAD.

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Acknowledgements

List of all contributors to the STANP trial. Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine: Yumi Sugawara, PhD; Department of Radiology, Tohoku University Graduate School of Medicine: Hidenobu Takagi, MD, PhD, Satoshi Higuchi, MD, Hideki Ota, MD, PhD, Kei Takase, MD, PhD; Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine: Kazuyuki Daitoku, MD, PhD, Ikuo Fukuda, MD, PhD; Department of Cardiovascular Surgery, Hirosaki Central Hospital: Hiroyuki Itaya, MD, PhD; Department of Cardiovascular Surgery, Tohoku Medical and Pharmaceutical University Hospital: Suguru Watanabe, MD, PhD; Department of Cardiovascular Surgery, Sendai Open Hospital: Seijiro Yoshida, MD, PhD; Department of Cardiovascular Surgery, Sendai Kousei Hospital: Masaki Hata, MD; Department of Cardiology, Sendai Kousei Hospital: Norio Tada, MD, PhD; Department of Cardiovascular Surgery, Aomori Prefectural Central Hospital: Koichi Nagaya, MD, PhD; Department of Cardiovascular Surgery, Iwate Prefectural Central Hospital: Katsuhiko Oda, MD, PhD; Department of Cardiovascular Surgery, Mito Medical Center: Kei Sakuma, MD, PhD; Department of Cardiovascular Surgery, Sendai City Hospital: Tetsuo Watanabe, MD, PhD.

Funding

None.

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Author notes

  1. Naoki Masaki and Kiichiro Kumagai contributed equally and should be considered co-first authors.

Authors and Affiliations

  1. Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Seiryocho, Aoba-ku, Sendai, 980-8574, Japan

    Naoki Masaki, Konosuke Sasaki, Satoshi Matsuo, Naotaka Motoyoshi, Osamu Adachi, Masatoshi Akiyama, Shunsuke Kawamoto, Koichi Tabayashi & Yoshikatsu Saiki

  2. Research Division of Sciences for Aortic Disease, Tohoku University Graduate School of Medicine, Sendai, Japan

    Kiichiro Kumagai

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  1. Naoki Masaki
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Consortia

For the STANP trial investigators

  • Yumi Sugawara
  • , Hidenobu Takagi
  • , Satoshi Higuchi
  • , Hideki Ota
  • , Kei Takase
  • , Kazuyuki Daitoku
  • , Ikuo Fukuda
  • , Hiroyuki Itaya
  • , Suguru Watanabe
  • , Seijiro Yoshida
  • , Masaki Hata
  • , Norio Tada
  • , Koichi Nagaya
  • , Katsuhiko Oda
  • , Kei Sakuma
  •  & Tetsuo Watanabe

Corresponding author

Correspondence to Yoshikatsu Saiki.

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Conflict of interest

The authors have no potential conflicts of interest.

Additional information

STANP trial investigators are listed in “Acknowledgements”.

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Masaki, N., Kumagai, K., Sasaki, K. et al. Suppressive effect of pitavastatin on aortic arch dilatation in acute stanford type B aortic dissection: analysis of STANP trial. Gen Thorac Cardiovasc Surg 66, 334–343 (2018). https://doi.org/10.1007/s11748-018-0916-z

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  • DOI: https://doi.org/10.1007/s11748-018-0916-z

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