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High-intensity statin therapy associated with lower mortality in PAD
High-intensity statin therapy was associated with improved survival in individuals with symptomatic peripheral artery disease vs. low- or moderate-intensity therapy, according to a study.
“Among patients with critical limb ischemia, the most severe manifestation of PAD, statin therapy has also been associated with reduced mortality and improved amputationfree survival,” T. Raymond Foley, MD, of the Denver VA Medical Center and University of Colorado School of Medicine, and colleagues wrote. “Despite compelling evidence and guideline recommendations, patients with PAD are undertreated medically and are significantly less likely than patients with CAD to receive statin therapy.”
Foley and colleagues included participants with symptomatic PAD who had undergone peripheral angiography and/or endovascular intervention from 2006 to 2013 at the University of California, Davis Medical Center. Participants were not taking any other lipid-lowering medications.
Among 909 participants, 69% were prescribed statins and 13.6% were treated with high-intensity statin therapy (atorvastatin 40 mg to 80 mg or rosuvastatin 20 mg to 40 mg).
Baseline characteristics and demographics were similar between low- or moderate-intensity statin therapy groups vs. the high-intensity group (LDL: 80 mg/dL vs. 87 mg/dL, P = .14; age: 68 years vs. 67 years, P =.25; smoking history: 76% vs. 80%, P = .42; diabetes: 54% vs. 48%, P = .17; hypertension: 88% vs. 89%, P = .78).
More participants on high-intensity statin therapy (75%) had CAD vs. those on low- or moderate-intensity therapy (56%; P = .0001).
Those prescribed high-intensity therapy were associated with decreased mortality (HR = 0.52; 95% CI, 0.33-0.81) and decreased major adverse CV events (HR = 0.58; 95% CI, 0.37-0.92) vs. low- or moderate-intensity therapy, after propensity weighting.
“Our data support current guideline recommendations by demonstrating improved survival in patients with PAD treated with [high-intensity] statins compared with [low- or moderate-intensity] statins. Consistent with previously published reports, our study suggests that many patients with PAD do not receive statin therapy, and even fewer receive [high-intensity] statin therapy. These findings highlight a need for ongoing education to raise awareness among providers and patients alike about the benefits of statin therapy in PAD,” the researchers wrote. – by Cassie Homer
Disclosures: Foley reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.