Abstract 3010: Statins in Intermittent Claudication: A Meta-Analysis
Background: Intermittent claudication is always been bothersome to patients with peripheral arterial disease. These patients suffer lower limb pain limiting their activity and independence. The benefit of statins among claudicants still remains unclear. The objective of this meta-analysis is to determine the efficacy of statin treatment among patients with intermittent claudication.
Methods: Clinical trials were identified from Medline search, PUBMED, and Cochrane collaboration databases 1999 to 2006 using the following keywords: statins, claudication, peripheral arterial disease, peripheral vascular disease, randomized controlled trials and MESH terms Hydroxymethylglutaryl-Coa Reductase Inhibitors, peripheral vascular disease, and intermittent claudication. A total of 12 articles were queried, 8 of which are RCTs and were subjected to data extraction and quality scale. Independent quality assessment scale and the inclusion criteria were strictly applied. A total of 3 trials were included in the study. All included studies were randomized controlled trials involving a total of 380 PAD patients with intermittent claudication (Fontaine class II) and an Ankle-Brachial index of less than 0.90. Patients with previous surgery/angioplasty for PAOD, any condition that limits their ability to perform exercise test like previous MI patients/ CABG within 6 months, unstable angina, neurologic disease, arthritis, uncontrolled hypertension, DVT before 3 months of randomization. Patients who had previously been treated with statins or other cholesterol lowering drugs were also excluded.
Main results: The result showed that the use of statins significantly improves the mean walking distance from the baseline as compared with the placebo with 2.86 at 95% CI (2.53 – 3.19), P-value of 0.00002. The results in terms of pain-free walking distance also showed significant improvement with the use of statins as compared with the placebo with 2.56 at 95% CI (2.29 - 2.83), P-value of 0.00002.
Conclusions: Statins are beneficial among claudicant patients with signinficant improvement of mean walking distance and increase in pain-free walking distance with treatment duration of 6 to 12 months.