Association between statin-use and mobility and long-term survival after major lower limb amputation

Area of Science:

• Cardiovascular Medicine
• Rehabilitation Medicine
• Pharmacology

Background:

• Major amputation for lower limb arterial disease necessitates extensive rehabilitation.
• Prosthetic mobility and long-term survival are critical outcomes for these patients.
• The role of statins, commonly used for cardiovascular disease, in post-amputation outcomes is not well-defined.

Purpose of the Study:

• To investigate the association between statin use and prosthetic mobility.
• To determine the impact of statin use on long-term survival in patients post-lower limb amputation.
• To explore the combined effects of statins and antithrombotic drugs on patient outcomes.

Main Methods:

• Retrospective analysis of prospectively maintained data from 2008-2020.
• Patients were grouped based on statin use and combination with antiplatelet or anticoagulant therapy.
• Outcomes assessed included prosthetic mobility (SIGAM score, timed-up-go, 2-min walking distance) and long-term survival, analyzed using regression and survival analyses.

Main Results:

• Statin use was observed in 64.7% of 771 patients, with lower rates in females.
• Statin users demonstrated significantly better prosthetic independence, improved timed-up-go test results, and enhanced long-term survival (HR 0.59).
• Combination therapy with statins and antiplatelets showed the most significant survival benefit (HR 0.51), a finding consistent in sensitivity analyses.

Conclusions:

• Statin use is associated with improved mobility and survival in patients rehabilitating after lower limb amputation.
• The combination of statins with antiplatelets appears particularly beneficial for long-term survival.
• Further research is needed to address gender disparities in statin prescription and confirm causality.