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Statin use promotes limb salvage, survival after PAD procedures
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Among patients with peripheral artery disease who underwent a surgical or endovascular intervention, statin use after the procedure was associated with better odds of survival and limb salvage, researchers reported.
“Statin use independently and significantly improved overall survival and limb salvage in patients with PAD after intervention,” Gaurav M. Parmar, MD, MPH, from the division of vascular surgery and endovascular therapy at the University of Alabama at Birmingham, said in a press release.
The researchers analyzed 488 patients with PAD (44% women; 39% nonwhite) who had an endovascular or surgical procedure in 2009 or 2010. Among the cohort, 41% took statins after their procedure while 56% received antiplatelets and 26% received oral anticoagulants.
“An important finding from this study is that the prevalence of both statin and antiplatelet therapy was low in our patient population, despite the known cardiovascular benefits,” Parmar said in the release. “This may be due to lack of physician awareness or a major focus on limb-related rather than cardiovascular outcomes.”
The primary outcomes were survival and freedom from amputation. The researchers also determined predictors of ongoing statin use. Follow-up occurred for up to 88 months.
During follow-up, 11% of patients died and 9% required a major amputation, Parmar and colleagues wrote.
Compared with nonusers, statin users were more likely to be men (P = .03), to be white (P = .03), to be smokers (P < .01), to have CAD (P < .01), to have hypertension (P < .01) and to have diabetes (P < .01), according to the researchers.
After adjustment for severity of disease, traditional risk factors and concurrent antiplatelet use, statin use was associated with improved survival (P = .04) and limb salvage (HR = 0.3; 95% CI, 0.1-0.7) compared with nonuse.
Antiplatelet therapy was associated with improved survival (P < .01) but not limb salvage (P = .13), the researchers wrote. They also found that dual antiplatelet therapy did not yield better survival or limb salvage rates compared with monotherapy.
“Patients with PAD continue to receive suboptimal medical therapy compared with patients with CAD owing to a lack of physician awareness, presence of atypical symptoms or a major focus on limb-related rather than cardiovascular outcomes,” Parmar said in the release. “Efforts are ongoing within our vascular division to improve use of these medications across our institution.” – by Erik Swain
Disclosures: The authors report no relevant financial disclosures.
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