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Statins and statin intensity in peripheral artery disease
Marios Sagris1, Ioannis Katsaros2, Stefanos Giannopoulos3
1Department of Internal Medicine, General Hospital of Nikaia, Piraeus, Athens, Greece.
VASA. Zeitschrift Fur Gefasskrankheiten
|June 8, 2022
Summary
Statins significantly reduce mortality and amputation risk in peripheral artery disease (PAD) patients. High-intensity statin therapy further improves outcomes, highlighting their crucial role in managing PAD.
Area of Science:
- Cardiology
- Vascular Medicine
- Pharmacology
Background:
- Peripheral artery disease (PAD) affects over 202 million individuals globally.
- Suboptimal statin utilization is common in PAD patients, despite guidelines recommending them as first-line therapy.
- Statins are crucial for managing lipid levels and cardiovascular risk in PAD.
Purpose of the Study:
- To evaluate the impact of statin therapy on lower extremity PAD outcomes.
- To compare the effectiveness of high-intensity versus low-intensity statin treatment in PAD patients.
- To analyze the association of statins with mortality, amputation, and cardiovascular events in PAD.
Main Methods:
- Systematic review and meta-analysis adhering to PRISMA guidelines.
- Inclusion of studies comparing statins versus no statins, or high-intensity versus low-intensity statins in PAD patients.
- Exclusion of studies focusing solely on critical limb-threatening ischemia (CLTI).
- Medline (PubMed) database search up to January 31, 2021, followed by random-effects meta-analysis.
Main Results:
- Meta-analysis included 39 studies with 275,670 patients.
- Statin use significantly reduced all-cause mortality (42%) and cardiovascular death (43%).
- Statin use increased amputation-free survival (56%) and reduced amputation risk (35%) and loss of patency (46%).
- High-intensity statin therapy showed a 36% reduction in all-cause mortality compared to low-intensity therapy.
Conclusions:
- Statin treatment is associated with significant reductions in mortality, MACE, and amputation risk in PAD patients.
- Higher intensity statin therapy appears to confer improved outcomes.
- Statins are a cornerstone therapy for improving prognosis in peripheral artery disease.
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