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

Publication ,  Journal Article
Kumbhani, DJ; Steg, PG; Cannon, CP; Eagle, KA; Smith, SC; Goto, S; Ohman, EM; Elbez, Y; Sritara, P; Baumgartner, I; Banerjee, S; Creager, MA ...
Published in: Eur Heart J
November 1, 2014

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.

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Published In

Eur Heart J

DOI

EISSN

1522-9645

Publication Date

November 1, 2014

Volume

35

Issue

41

Start / End Page

2864 / 2872

Location

England

Related Subject Headings

  • Treatment Outcome
  • Registries
  • Physician's Role
  • Peripheral Arterial Disease
  • Male
  • Ischemia
  • Intermittent Claudication
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Humans
  • Female
 

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Kumbhani, D. J., Steg, P. G., Cannon, C. P., Eagle, K. A., Smith, S. C., Goto, S., … REACH Registry Investigators, . (2014). Statin therapy and long-term adverse limb outcomes in patients with peripheral artery disease: insights from the REACH registry. Eur Heart J, 35(41), 2864–2872. https://doi.org/10.1093/eurheartj/ehu080
Kumbhani, Dharam J., Ph Gabriel Steg, Christopher P. Cannon, Kim A. Eagle, Sidney C. Smith, Shinya Goto, E Magnus Ohman, et al. “Statin therapy and long-term adverse limb outcomes in patients with peripheral artery disease: insights from the REACH registry.Eur Heart J 35, no. 41 (November 1, 2014): 2864–72. https://doi.org/10.1093/eurheartj/ehu080.
Kumbhani DJ, Steg PG, Cannon CP, Eagle KA, Smith SC, Goto S, et al. Statin therapy and long-term adverse limb outcomes in patients with peripheral artery disease: insights from the REACH registry. Eur Heart J. 2014 Nov 1;35(41):2864–72.
Kumbhani, Dharam J., et al. “Statin therapy and long-term adverse limb outcomes in patients with peripheral artery disease: insights from the REACH registry.Eur Heart J, vol. 35, no. 41, Nov. 2014, pp. 2864–72. Pubmed, doi:10.1093/eurheartj/ehu080.
Kumbhani DJ, Steg PG, Cannon CP, Eagle KA, Smith SC, Goto S, Ohman EM, Elbez Y, Sritara P, Baumgartner I, Banerjee S, Creager MA, Bhatt DL, REACH Registry Investigators. Statin therapy and long-term adverse limb outcomes in patients with peripheral artery disease: insights from the REACH registry. Eur Heart J. 2014 Nov 1;35(41):2864–2872.
Journal cover image

Published In

Eur Heart J

DOI

EISSN

1522-9645

Publication Date

November 1, 2014

Volume

35

Issue

41

Start / End Page

2864 / 2872

Location

England

Related Subject Headings

  • Treatment Outcome
  • Registries
  • Physician's Role
  • Peripheral Arterial Disease
  • Male
  • Ischemia
  • Intermittent Claudication
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Humans
  • Female