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Serum Low-Density Lipoprotein Cholesterol Level After Endovascular Therapy in Patients With Claudication

Yusuke Tomoi1, Kyohei Yamaji1, Yoshimitsu Soga1

  • 11 Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
|March 16, 2019
PubMed

Insights

Elevated low-density lipoprotein cholesterol (LDL-C) levels after endovascular therapy (EVT) for peripheral artery disease (PAD) increase cardiovascular death risk. Intensive LDL-C lowering may improve outcomes, especially for patients on statin therapy.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Surgery
  • Interventional Cardiology

Background:

  • Peripheral artery disease (PAD) affects lower limbs and increases cardiovascular risk.
  • Endovascular therapy (EVT) is a common treatment for symptomatic PAD.
  • Optimizing lipid management post-EVT is crucial for long-term outcomes.

Purpose of the Study:

  • To examine the association between low-density lipoprotein cholesterol (LDL-C) levels and 5-year cardiovascular death rates after EVT in PAD patients.
  • To investigate this association based on statin therapy status at discharge.

Main Methods:

  • Analysis of 935 patients with lower limb PAD who underwent EVT.
  • Correlation of LDL-C levels (measured 3-6 months post-EVT) with 5-year cardiovascular death (CVD).
  • Multivariate analysis to identify independent predictors of CVD, with a focus on LDL-C ≥100 mg/dL.

Main Results:

  • CVD occurred in 8.9% of patients over a median follow-up of 30.7 months.
  • Patients with LDL-C ≥100 mg/dL had a significantly higher 5-year CVD incidence (23.5% vs. 13.5%, p=0.03).
  • LDL-C ≥100 mg/dL was an independent predictor of CVD (adjusted HR 1.60, p=0.049), particularly in patients on statin therapy.

Conclusions:

  • Higher LDL-C levels (≥100 mg/dL) 3-6 months post-EVT for PAD are independently linked to increased CVD risk.
  • This association is more pronounced in patients receiving statin therapy.
  • Intensified LDL-C-lowering strategies may be necessary to enhance clinical outcomes in this patient population.
Abstract

Keywords:
cardiovascular deathendovascular therapylow-density lipoprotein cholesterolperipheral artery diseasestatin therapy

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