Statin use increases amputation-free survival in patients with critical limb ischemia

In patients with critical limb ischemia, statin use was associated with lower mortality and fewer major adverse cardiovascular and cerebrovascular events, as well as increased amputation-free survival, according to recent study results published in the Journal of the American College of Cardiology.

Researchers reviewed 380 patients with critical limb ischemia who underwent diagnostic angiography or therapeutic endovascular intervention from 2006-2012. Overall, 246 patients were prescribed statins. Patients prescribed statins had lower mean serum low-density lipoprotein (LDL) levels and more baseline comorbidities, including extensive lower extremity disease, diabetes, coronary artery disease and hypertension, according to study results.

Researchers found an association between statin therapy and lower 1-year rates of major adverse cardiovascular and cerebrovascular events, including stroke and myocardial infarction, and major amputation or death. Patients with LDL levels above 130mg/dL were at greater risk of major adverse cardiovascular and cerebrovascular events and mortality compared with patients with LDL levels lower than 130mg/dL.

“The improved rates of 1-year MACCE [major adverse cardiovascular and cerebrovascular events] with stain use strengthens the evidence supporting the guideline recommendations of statin therapy for all PAD patients, including those with even the most advanced stages of disease. Our finding of superior outcomes for patients with lower LDL levels also provides support for the use of LDL as a treatment target in patients with PAD. Future studies should determine the optimal statin type and dose, further explore potential treatment targets including low-density lipoprotein for statins in peripheral arterial disease, and investigate barriers to more widespread use of statins among patients with critical limb ischemia,” the researchers wrote.

For more information:

Westin GG. J Am Coll Cardiol. 2013; doi:10.1016/j.jacc.2013.09.073.

Disclosure: Yeo is on the Speakers Bureau for Abbott Vascular. Laird is a consultant for Boston Scientific, Covidien, Abbott, Bard and Medtronic.

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