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The rationale for using HMG-CoA reductase inhibitors ('statins') in peripheral arterial disease
1Center for Research, Prevention and Treatment of Atherosclerosis, Department of Medicine B, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Insights
Statins, or HMG-CoA reductase inhibitors, show promise in preventing cardiovascular events in peripheral arterial disease. Further research is needed to confirm their efficacy in various patient groups.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
Background:
- Atherosclerosis is a major cause of death globally.
- Statins (HMG-CoA reductase inhibitors) effectively lower lipids and reduce cardiovascular events in coronary atherosclerosis.
Purpose of the Study:
- To review current data on statin use for preventing and treating atherosclerosis outside the coronary arteries.
Main Methods:
- A literature search of clinical trials involving statins in extra-coronary atherosclerosis was conducted using PubMed.
Main Results:
- Peripheral arterial diseases, including cerebrovascular and lower extremity conditions, are linked to substantial cardiovascular risks.
- Small trials suggest statins may reduce cardiovascular morbidity and mortality in peripheral arterial disease patients.
- Statin benefits may stem from lipid reduction or pleiotropic effects.
Conclusions:
- Peripheral arterial disease is a significant cardiovascular risk factor, comparable to coronary artery disease.
- Evidence suggests statin therapy is beneficial for peripheral arterial disease, but larger studies are required.
- Further research should focus on statin efficacy in stable peripheral arterial disease and post-vascular surgery.
Unlabelled:
Atherosclerosis is a systemic process, and the leading cause of morbidity and mortality in the developed world. HMG-CoA reductase inhibitors ('statins') are potent lipid lowering drugs, which have been shown to reduce morbidity and mortality in patients with coronary atherosclerosis.
Objective:
To present the up-to-date data concerning statin use in the prevention and treatment of extra-coronary atherosclerosis.
Methods:
Clinical trials with statins in patients with extra-coronary atherosclerosis were searched for via PUBMED.
Findings And Conclusions:
The different forms of peripheral arterial disease (e.g. cerberovascular disease, lower extremity peripheral arterial disease) are associated with significant cardiovascular morbidity and mortality, and hence constitute a coronary artery disease equivalent in terms of published practice guidelines. There is some evidence from small randomized controlled trials that statin therapy decreases cardiovascular morbidity and mortality in patients with peripheral arterial disease. The mechanism of action of statins may derive from their lipid lowering properties, or from other, pleiotropic effects. Further, larger randomized controlled studies with statins are needed to evaluate the efficacy of statin therapy in patients with stable peripheral arterial disease and in those undergoing vascular or endovascular surgery.
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