+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Statin therapy and long-term adverse limb outcomes in patients with peripheral artery disease: insights from the REACH registry



Statin therapy and long-term adverse limb outcomes in patients with peripheral artery disease: insights from the REACH registry



European Heart Journal 35(41): 2864-2872



Due to a high burden of systemic cardiovascular events, current guidelines recommend the use of statins in all patients with peripheral artery disease (PAD). We sought to study the impact of statin use on limb prognosis in patients with symptomatic PAD enrolled in the international REACH registry. Statin use was assessed at study enrolment, as well as a time-varying covariate. Rates of the primary adverse limb outcome (worsening claudication/new episode of critical limb ischaemia, new percutaneous/surgical revascularization, or amputation) at 4 years and the composite of cardiovascular death/myocardial infarction/stroke were compared among statin users vs. non-users. A total of 5861 patients with symptomatic PAD were included. Statin use at baseline was 62.2%. Patients who were on statins had a significantly lower risk of the primary adverse limb outcome at 4 years when compared with those who were not taking statins [22.0 vs. 26.2%; hazard ratio (HR), 0.82; 95% confidence interval (CI), 0.72-0.92; P = 0.0013]. Results were similar when statin use was considered as a time-dependent variable (P = 0.018) and on propensity analysis (P < 0.0001). The composite of cardiovascular death/myocardial infarction/stroke was similarly reduced (HR, 0.83; 95% CI, 0.73-0.96; P = 0.01). Among patients with PAD in the REACH registry, statin use was associated with an ∼18% lower rate of adverse limb outcomes, including worsening symptoms, peripheral revascularization, and ischaemic amputations. These findings suggest that statin therapy not only reduces the risk of adverse cardiovascular events, but also favourably affects limb prognosis in patients with PAD.

(PDF emailed within 0-6 h: $19.90)

Accession: 055911195

Download citation: RISBibTeXText

PMID: 24585266

DOI: 10.1093/eurheartj/ehu080


Related references

Geographic variation and risk factors for systemic and limb ischemic events in patients with symptomatic peripheral artery disease: Insights from the REACH Registry. Clinical Cardiology 40(9): 710-718, 2017

Early and long-term outcomes of bioresorbable vascular scaffolds in the treatment of patients with coronary artery disease in real-world clinical practice - insights from the ZABRZE-BVS registry. Postepy W Kardiologii Interwencyjnej 14(4): 338-346, 2019

Long-term effects of ezetimibe-plus-statin therapy on low-density lipoprotein cholesterol levels as compared with double-dose statin therapy in patients with coronary artery disease. Atherosclerosis 224(2): 454-456, 2013

Cardiovascular risk factor control and outcomes in peripheral artery disease patients in the Reduction of Atherothrombosis for Continued Health (REACH) Registry. Atherosclerosis 204(2): E86-E92, 2008

Statin Therapy Reduces Future Risk of Lower-Limb Amputation in Patients With Diabetes and Peripheral Artery Disease. Journal of Clinical Endocrinology and Metabolism 102(7): 2373-2381, 2017

Targeting risk factors to goals is associated with better outcomes among patients with coronary artery bypass surgery: Insights from the REACH registry. 2007

Clinical Outcomes and Cost Comparisons of Stent and Non-Stent Interventions in Infrainguinal Peripheral Artery Disease: Insights From the Excellence in Peripheral Artery Disease (XLPAD) Registry. Journal of Invasive Cardiology 31(1): 1-9, 2019

Effects of Long-Term Statin Therapy in Coronary Artery Disease Patients with or without Chronic Kidney Disease. Disease Markers 2015: 252564, 2016

Long-Term Comparative Outcomes of Patients With Peripheral Artery Disease With and Without Concomitant Coronary Artery Disease. American Journal of Cardiology 119(8): 1146-1152, 2017

Long-term cardiovascular outcomes in patients with atrial fibrillation and atherothrombosis in the REACH Registry. International Journal of Cardiology 170(3): 413-418, 2014

Markers of inflammation and statin therapy in relation to long-term mortality in patients with coronary artery disease. Circulation 104(17 Supplement): II 805, October 23, 2001

CKD and Acute and Long-Term Outcome of Patients with Peripheral Artery Disease and Critical Limb Ischemia. Clinical Journal of the American Society of Nephrology 11(2): 216-222, 2017

Prognostic and therapeutic implications of statin and aspirin therapy in individuals with nonobstructive coronary artery disease: results from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter registry) registry. Arteriosclerosis, Thrombosis, and Vascular Biology 35(4): 981-989, 2015

Impact of Lipoprotein (a) on Long-Term Outcomes in Patients with Coronary Artery Disease Treated with Statin After a First Percutaneous Coronary Intervention. Journal of Atherosclerosis and Thrombosis 24(11): 1125-1131, 2017

Long term outcomes in diabetic patients treated with atherectomy for peripheral artery disease. Cardiology Journal 2018, 2018