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Higher-intensity statins reduce mortality in PAD
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PARIS — Patients with peripheral artery disease who maintained use of high-intensity statin therapy had significantly lower mortality than those who reduced the intensity of statin treatment or stopped taking statins, researchers reported.
These findings support the “it is never too late” strategy of intensive, sustained therapy compared with discontinuation or statin dose reduction strategies which may have deleterious effects, Joern Fredrik Dopheide, MD, of the division of angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, Switzerland, said during a presentation at the European Society of Cardiology Congress.
Researchers found that at 50 months, patients with PAD who were on intensified statin medication had lower mortality (10%) compared with those who reduced their dosage (43%) or stopped their statin (33%; P < .05).
In addition, patients who had never taken a statin had a higher mortality rate (34%) compared with those who had previously taken statins (20%) and those who started on a statin during the study period (15%; P < .01), according to the researchers.
During the study period, decrease in LDL was greatest in those taking high-intensity statins (P < .01), the researchers found.
“All PAD patients should take statins, preferably very potent statins, like rosuvastatin 40 mg or atorvastatin 80 mg, or at the highest tolerable dose,” Dopheide said in a press release. “In the rare case of statin intolerance, which was around 2% in our study, alternative lipid-lowering therapies must be considered.”
In the single-center observational study, researchers studied survival in a cohort of 691 patients with symptomatic PAD, of whom 73% were on statins, to determine whether adherence to treatment was associated with survival. They analyzed baseline and follow up measurements of statin dosage, LDL levels achieved and survival.
At the 50-month follow up, the proportion of patients with PAD on statins increased to 81%, dose increased from 50 mg per day to 58 mg per day and LDL decreased from 97 mg/dL to 82 mg/dL.
“The study shows that adherence to statins is essential for the best prognosis,” Dopheide said in the release. “We also show that it is never too late to start medication and benefit from it. On top of that, it is crucial not to reduce the dose because LDL cholesterol levels rise again, thus increasing the overall risk on top of the residual risk for further events.” – by Scott Buzby
Reference:
Dopheide JF, et al. Abstract P5363. Presented at: European Society of Cardiology Congress; Aug. 31 to Sept. 4, 2019; Paris.
Disclosure: Dopheide reports no relevant financial disclosures.