Foley TR, Singh GD, Kokkinidis DG, Choy HK, Pham T, Amsterdam EA, Rutledge JC, Waldo SW, Armstrong EJ, Laird JR, et al.
Journal of the American Heart Association. Date of publication 2017 Jul 15;volume 6(7):.
1. J Am Heart Assoc. 2017 Jul 15;6(7). pii: e005699. doi: 10.1161/JAHA.117.005699.
High-Intensity Statin Therapy Is Associated With Improved Survival in Patients
With Peripheral Artery Disease.
Foley TR(1), Singh GD(2), Kokkinidis DG(1), Choy HK(2), Pham T(2), Amsterdam
EA(2), Rutledge JC(2), Waldo SW(1), Armstrong EJ(3), Laird JR(2).
Author information:
(1)Section of Cardiology, Denver VA Medical Center and University of Colorado
School of Medicine, Aurora, CO.
(2)Section of Cardiology, University of California-Davis, Sacramento, CA.
(3)Section of Cardiology, Denver VA Medical Center and University of Colorado
School of Medicine, Aurora, CO ehrin.armstrong@gmail.com.
Erratum in
J Am Heart Assoc. 2019 May 21;8(10):e002305.
BACKGROUND: The relative benefit of higher statin dosing in patients with
peripheral artery disease has not been reported previously. We compared the
effectiveness of low- or moderate-intensity (LMI) versus high-intensity (HI)
statin dose on clinical outcomes in patients with peripheral artery disease.
METHODS AND RESULTS: We reviewed patients with symptomatic peripheral artery
disease who underwent peripheral angiography and/or endovascular intervention
from 2006 to 2013 who were not taking other lipid-lowering medications. HI statin
use was defined as atorvastatin 40-80 mg or rosuvastatin 20-40 mg. Baseline
demographics, procedural data, and outcomes were retrospectively analyzed. Among
909 patients, 629 (69%) were prescribed statins, and 124 (13.6%) were treated
with HI statin therapy. Mean low-density lipoprotein level was similar in
patients on LMI versus HI (80±30 versus 87±44 mg/dL, P=0.14). Demographics
including age (68±12 versus 67±10 years, P=0.25), smoking history (76% versus
80%, P=0.42), diabetes mellitus (54% versus 48%, P=0.17), and hypertension (88%
versus 89%, P=0.78) were similar between groups (LMI versus HI). There was a
higher prevalence of coronary artery disease (56% versus 75%, P=0.0001) among
patients on HI statin (versus LMI). After propensity weighting, HI statin therapy
was associated with improved survival (hazard ratio for mortality: 0.52; 95%
confidence interval, 0.33-0.81; P=0.004) and decreased major adverse
cardiovascular events (hazard ratio: 0.58; 95% confidence interval 0.37-0.92,
P=0.02).
CONCLUSIONS: In patients with peripheral artery disease who were referred for
peripheral angiography or endovascular intervention, HI statin therapy was
associated with improved survival and fewer major adverse cardiovascular events
compared with LMI statin therapy.
© 2017 The Authors. Published on behalf of the American Heart Association, Inc.,
by Wiley.
DOI: 10.1161/JAHA.117.005699
PMCID: PMC5586293
PMID: 28711864 [Indexed for MEDLINE]
