Abstract 11809: Efficacy of Statin Treatment After Endovascular Therapy for Isolated Below-the-knee Disease in Patients With Critical Limb Ischemia
Backgroud: The efficacy of statin treatment for coronary artery disease (CAD) is already established, but little is known about the efficacy of statin treatment after endovascular therapy (EVT) for isolated below-the-knee (BTK) disease in patients with critical limb ischemia (CLI). Therefore, we investigated the effect of statin treatment on outcomes in patient with CLI.
Methods: From March 2004 to June 2011, 812 patients (984 limbs, 69.0% male, 168 treated with statin, 71.6±10.0 years old) with CLI underwent EVT for de novo isolated BTK lesion. Their data were retrospective multicenter analyzed. Outcome measures were overall survival, amputation-free survival (AFS), cardiovascular death, limb salvage, freedom from repeat revascularization, and major adverse limb event (MALE). Mean follow-up duration was 19.4 ± 17.6 months.
Result: Overall survival and AFS and freedom from repeat revascularization at 4 years were significantly higher in statin treatment group (64.5% vs 45.9%, P=0.004; 64.1% vs 43.0%, P=0.003; 56.4% vs 45.4%, P=0.03; respectively). However, cardiovascular death and limb salvage rate and major adverse limb event (MALE) at 4 years did not differ significantly between two groups (86.0% vs 75.2%, P=0.11; 87.2% vs 87.7%, P=0.39; 84.4% vs 82.9%, P=0.64; respectively). On subgroup analysis, ambulatory group (513 patients) with baseline variables, statin treatment was improved overall survival (hazard ratio [HR], 0.54; 95% confidential interval [CI] 0.29-0.97; adjusted P=0.04) and tending to be effective for prevention of AFS (HR, 0.63; 95% CI, 0.35-1.07; adjusted P=0.086). There was no significant difference in repeat revascularization, cardiovascular death, limb salvage rate, and MALE between the groups.
Conclusion: For ambulatory patient, statin treatment may improve overall survival and AFS after EVT for isolated BTK disease in patients with CLI.
- © 2012 by American Heart Association, Inc.