Statins may improve survival for patients with critical limb ischemia

Patients with critical limb ischemia who use statins may live longer and also be at lower risk for amputation and major adverse cardiovascular and cerebrovascular events, a study published in the Feb. 25 issue of the Journal of the American College of Cardiology found.

University of California, Davis researchers identified 380 patients with critical limb ischemia (CLI) using a registry that tracks patients with peripheral artery disease (PAD) who underwent diagnostic angiography and/or endovascular intervention at UC Davis Medical Center between 2006 and 2012.

The investigators compared the CLI patients on statin therapy with those who were not. The primary endpoint was a composite of major adverse cardiovascular and cerebrovascular events (MACCE), considered any death, heart attack or stroke within a year of the procedure. 

Of the 380 patients, 66 percent used statins. The average serum low-density lipoprotein (LDL) level was lower in the statin group, but these patients also had more baseline comorbidities. After adjustment, the investigators found statin therapy associated with lower rates of MACCE (hazard ratio [HR] 0.53), mortality (HR 0.49) and major amputation or death (HR 0.53) one year after the procedure.

They also found an association between statin use and improved lesion patency in patients who underwent infrapopliteal angioplasty. HRs of MACCE were lower among patients with lower LDL cholesterol levels. 

The authors, led by Gregory G. Westin, AB, MAS, said their findings support the use of statins in PAD patients. “Future studies should determine the optimal statin type and dose, further explore potential treatment targets including LDL for statins in PAD patients, and investigate barriers to more widespread use of statins among patients with CLI,” they wrote.