Statin therapy and long-term adverse limb outcomes in patients with peripheral artery disease: insights from the REACH registry

Kumbhani, Dharam J; Steg, Ph Gabriel; Cannon, Christopher P; Eagle, Kim A; Smith, Sidney C; Goto, Shinya; Ohman, E Magnus; Elbez, Yedid; Sritara, Piyamitr; Baumgartner, Iris; Banerjee, Subhash; Creager, Mark A; Bhatt, Deepak L (2014). Statin therapy and long-term adverse limb outcomes in patients with peripheral artery disease: insights from the REACH registry. European Heart Journal, 35(41), pp. 2864-2872. Oxford University Press 10.1093/eurheartj/ehu080

[img] Text
eurheartj.ehu080.full.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (421kB) | Request a copy
[img]
Preview
Text
ehu080.pdf - Other
Available under License Publisher holds Copyright.

Download (517kB) | Preview

AIMS Due to a high burden of systemic cardiovascular events, current guidelines recommend the use of statins in all patients with peripheral artery disease (PAD). We sought to study the impact of statin use on limb prognosis in patients with symptomatic PAD enrolled in the international REACH registry. METHODS Statin use was assessed at study enrolment, as well as a time-varying covariate. Rates of the primary adverse limb outcome (worsening claudication/new episode of critical limb ischaemia, new percutaneous/surgical revascularization, or amputation) at 4 years and the composite of cardiovascular death/myocardial infarction/stroke were compared among statin users vs. non-users. RESULTS A total of 5861 patients with symptomatic PAD were included. Statin use at baseline was 62.2%. Patients who were on statins had a significantly lower risk of the primary adverse limb outcome at 4 years when compared with those who were not taking statins [22.0 vs. 26.2%; hazard ratio (HR), 0.82; 95% confidence interval (CI), 0.72-0.92; P = 0.0013]. Results were similar when statin use was considered as a time-dependent variable (P = 0.018) and on propensity analysis (P < 0.0001). The composite of cardiovascular death/myocardial infarction/stroke was similarly reduced (HR, 0.83; 95% CI, 0.73-0.96; P = 0.01). CONCLUSION Among patients with PAD in the REACH registry, statin use was associated with an ∼18% lower rate of adverse limb outcomes, including worsening symptoms, peripheral revascularization, and ischaemic amputations. These findings suggest that statin therapy not only reduces the risk of adverse cardiovascular events, but also favourably affects limb prognosis in patients with PAD.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Angiology

UniBE Contributor:

Baumgartner, Iris

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0195-668X

Publisher:

Oxford University Press

Language:

English

Submitter:

Catherine Gut

Date Deposited:

01 Oct 2014 12:23

Last Modified:

04 Nov 2019 05:38

Publisher DOI:

10.1093/eurheartj/ehu080

PubMed ID:

24585266

Uncontrolled Keywords:

Claudication, Morbidity, Peripheral vascular disease, Registry, Statins

BORIS DOI:

10.7892/boris.54441

URI:

https://boris.unibe.ch/id/eprint/54441

Actions (login required)

Edit item Edit item
Provide Feedback