Peripheral Arterial Disease: Effect of Statin Therapy and Dose on CV and Limb Outcomes

Takeaway

• In patients with peripheral arterial disease (PAD), statin therapy was associated with a lower risk of all-cause mortality (ACM), major adverse cardiac events (MACE), cardiovascular mortality (CVM) and amputations.
• Higher doses of statins showed a significant improvement in ACM, CVM and amputations.

Why this matters

• Findings strengthen the evidence for the protective effects of statin use in PAD, while also supporting the effectiveness of higher doses in preventing detrimental patient outcomes.

Study design

• UK researchers performed a meta-analysis of 24 studies (n=268,611).
• Primary outcomes: ACM and major lower limb amputation.
• Secondary outcomes: CVM and MACE (non-fatal cerebrovascular accident, myocardial infarction and CV death).
• Funding: None.

Key results

• Statin therapy vs no statins was significantly associated with a lower risk of:
  • ACM (OR, 0.68; 95% CI, 0.60-0.76; I², 56% and HR, 0.74; 95% CI, 0.70-0.78; P<.001 for both);
  • MACE (OR, 0.84; 95% CI, 0.78-0.92; P<.001 and HR, 0.78; 95% CI, 0.65-0.93);
  • amputations (HR, 0.64; 95% CI, 0.53-0.78; P<.001; I², 81%); and
  • CVM (OR, 0.55; 95% CI, 0.38-0.78; P=.001; I², 90%).
• High-dose statin therapy was significantly associated with a lower risk of (HR; 95% CI):
  • ACM (0.74; 0.62-0.89; P=.001; I², 76%);
  • CVM (0.71; 0.63-0.80); and
  • amputations (0.78; 0.69-0.90).
• High-dose statin therapy was not significantly associated with a reduced risk of MACE (OR, 0.77; 95% CI, 0.49-1.21).

Limitations

• Heterogeneity among studies.

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.