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Elevated LDL heightens risk after endovascular therapy for PAD

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MUNICH — Among patients who underwent endovascular therapy for peripheral artery disease, those who had LDL levels of at least 100 mg/dL 3 to 6 months after the procedure had elevated risk for CV death, according to data presented at the European Society of Cardiology Congress.

The difference was more pronounced in patients taking statin therapy at discharge, Yusuke Tomoi, MD, from the department of cardiology at Kokura Medical Hospital in Kitakyushu, Japan, and colleagues reported in a poster presentation.

Tomoi and colleagues analyzed 935 patients (mean age, 72 years; 76% men) who underwent endovascular therapy for PAD to determine if LDL levels achieved 3 to 6 months after the procedure had any effect on clinical outcomes.

The primary endpoint was CV death. Median follow-up was 30.7 months.

CV death during follow-up was higher in those who had LDL levels of at least 100 mg/dL 3 to 6 months after the procedure than in those who had LDL levels less than 100 mg/dL at that time (23.5% vs. 13.5%; log-rank P = .03), according to the researchers.

The difference was even more significant in the 509 patients who were on statin therapy at discharge (25.2% vs. 10.9%; log-rank P = .02), but was not present in the 426 patients not on statin therapy at discharge (log-rank P = .64).

In a multivariable model, LDL levels of at least 100 mg/dL 3 to 6 months after the procedure was an independent predictor of CV death (HR = 1.6; 95% CI, 1.001-2.59), as were age (HR = 1.04; 95% CI, 1.02-1.08), chronic kidney disease (HR = 3.72; 95% CI, 1.75-9.22), hemodialysis (HR = 2.82; 95% CI, 1.65-4.76), HF (HR = 2.15; 95% CI, 1.21-3.69) and preprocedural ankle-brachial index (HR = 0.2; 95% CI, 0.07-0.62).

The results suggest “the possibility of improving clinical outcomes by intensive LDL-C-lowering therapy,” Tomoi and colleagues wrote in the poster. – by Erik Swain

Reference:

Tomoi Y, et al. Abstract P1635. Presented at: European Society of Cardiology Congress; Aug. 25-29, 2018; Munich.

Disclosures: The authors report no relevant financial disclosures.