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Statins may lower amputation risk for patients with PAD

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Patients with peripheral artery disease assigned statin therapy may have a lower risk for amputation than patients not assigned statins, researchers reported at the American Heart Association’s Arteriosclerosis, Thrombosis and Vascular Biology/Peripheral Vascular Disease Scientific Sessions.

“PAD ... is the next cardiovascular epidemic,” Shipra Arya, MD, SM, assistant professor in the division of vascular surgery at Emory University School of Medicine and staff physician at Atlanta VA Medical Center, said in a press release. “It is poorly recognized and not adequately treated compared to heart disease — and research is lacking on the optimal use of statins for PAD patients.”

Using the VA database, Arya and colleagues identified 208,275 veterans (98% men; mean age, 67 years) with PAD and followed them for 5.2 years, noting statin therapy status. Patients were divided into three groups: those receiving high-dose statins, low- to moderate-dose statins and no statin therapy. Primary endpoints were risk for incident amputation and mortality at 1, 3 and 5 years.

Overall, 17,643 amputations and 99,951 deaths were reported during the study period. Patients on high-dose statins had a 33% lower risk for amputation (adjusted HR = 0.67; 95% CI, 0.63-0.72) compared with patients not receiving statin therapy (adjusted HR = 0.71; 95% CI, 0.68-0.73). Patients assigned a low- or moderate-dose statin had a 22% lower risk for amputation compared with the no-statin group.

According to Arya, this is “one of the largest population-based studies on PAD and suggests patients who have been diagnosed with PAD should be considered for placement on high-dose statins upon diagnosis if they can tolerate it, along with other medical management, including smoking cessation, antiplatelet therapy and a walking program.” – by Tracey Romero

Reference:

Arya S, et al. Abstract 343. Presented at: American Heart Association’s Arteriosclerosis, Thrombosis and Vascular Biology/Peripheral Vascular Disease 2016 Scientific Sessions; May 5-7, 2016; Nashville, Tenn.

Disclosure: The researchers report no relevant financial disclosures. This study was funded by the AHA and Atlanta VA Medical center.