PAD patients taking statins may be at decreased risk for death
MedWire News: Statins may be associated with a decreased risk for death from all causes and cardiovascular disease (CVD) in patients with peripheral arterial disease (PAD), US research suggests.
However, individuals with elevated levels of C-reactive protein (CRP) or D-dimer did not appear to benefit from statin treatment more than others.
The study included 579 patients with lower extremity PAD who were diagnosed at one of three non-invasive vascular laboratories in the Chicago area.
Statin use was determined at baseline and at each annual visit over a mean follow-up of 3.7 years. CRP and D-dimer levels were also measured at baseline.
Overall, 242 (42%) participants were taking a statin at baseline, and 129 (22%) died during follow-up.
Statin use was associated with significantly lower all-cause mortality (hazard ratio [HR]=0.51) and CVD mortality (HR=0.36) compared with no statin use, after adjusting for age, gender, race, comorbidities, ankle brachial index, cholesterol, and other confounders.
Further analysis revealed that statin therapy was only significantly associated with lower all-cause and total mortality among patients with baseline CRP values greater than the median of 2.6 mg/l (HR=0.44 and 0.20, respectively).
The same was true among patients with baseline D-dimer levels above the median of 0.65 µg/ml, with corresponding HRs of 0.49 and 0.26, report Mary McDermott (Northwestern University, Chicago, Illinois) and colleagues.
Nonetheless, they note in the American Journal of Cardiology that no statistically significant interaction was found between high versus low CRP or D-dimer levels and statin use in the analyses of statin use with mortality.
“These latter findings have demonstrated that among the 579 participants with PAD, participants with baseline CRP or D-dimer values greater than the median did not have significantly greater benefit from statin use than those with baseline CRP or D-dimer values less than the median,” they conclude.
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By Anita Wilkinson