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Impact of Statin Treatment Intensity after Endovascular Revascularization on Lower Extremity Peripheral Artery Disease

김병규|김병옥|변영섭|진무년|이혜영|김광실|서종권
연세대학교의과대학 (Yonsei University College of Medicine)|2022.04|Yonsei Medical Journal|제63권 제4호|pp. 333-341|DOI 10.3349/ymj.2022.63.4.333

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참고문헌

키워드

Peripheral artery diseasestatinendovascular revascularizationmajor adverse cardiovascular event
주제분류의학일반

초록

Purpose: Only a few Asian studies have discussed the impact of statin intensity on clinical outcomes in patients with peripheralartery disease (PAD). We aimed to investigate the clinical impact of statin intensity in patients with PAD after endovascular revascularization. Materials and Methods: From April 2009 to June 2019, 376 patients with lower extremity PAD treated with endovascular revascularizationwere enrolled. They were classified into three groups according to statin intensity: no-statin, low-to-moderate intensity(LMI), and high-intensity (HI). The primary outcomes were major adverse cardiovascular events (MACE) and major adverselimb events (MALE). Results: During the 40-month follow-up, MACE occurred less frequently in the HI and LMI groups than the no-statin group(11.4% vs. 16.0% vs. 39%, p<0.001). In adjusted Cox models, the HI group had the fewest MACE [hazard ratio (HR): 0.447; 95%confidence interval (CI): 0.244–0.834; p=0.018] and MALE (HR: 0.360; 95% CI: 0.129–1.006; p=0.051) events, while the LMI grouphad fewer MACE (HR: 0.571; 95% CI: 0.326–1.0; p=0.050) events than the no-statin group. HI statin therapy was associated withbetter outcomes in terms of MALE (HR: 0.432; 95% CI: 0.223–0.837; p=0.003) than LMI statin therapy after inverse probabilitytreatment weighting analysis. Conclusion: HI and LMI statin use is associated with a significant reduction in MACE events than no-statin use. HI statin use wasassociated with better MALE outcomes than no-statin or LMI statin use.

Abstract

Purpose: Only a few Asian studies have discussed the impact of statin intensity on clinical outcomes in patients with peripheralartery disease (PAD). We aimed to investigate the clinical impact of statin intensity in patients with PAD after endovascular revascularization. Materials and Methods: From April 2009 to June 2019, 376 patients with lower extremity PAD treated with endovascular revascularizationwere enrolled. They were classified into three groups according to statin intensity: no-statin, low-to-moderate intensity(LMI), and high-intensity (HI). The primary outcomes were major adverse cardiovascular events (MACE) and major adverselimb events (MALE). Results: During the 40-month follow-up, MACE occurred less frequently in the HI and LMI groups than the no-statin group(11.4% vs. 16.0% vs. 39%, p<0.001). In adjusted Cox models, the HI group had the fewest MACE [hazard ratio (HR): 0.447; 95%confidence interval (CI): 0.244–0.834; p=0.018] and MALE (HR: 0.360; 95% CI: 0.129–1.006; p=0.051) events, while the LMI grouphad fewer MACE (HR: 0.571; 95% CI: 0.326–1.0; p=0.050) events than the no-statin group. HI statin therapy was associated withbetter outcomes in terms of MALE (HR: 0.432; 95% CI: 0.223–0.837; p=0.003) than LMI statin therapy after inverse probabilitytreatment weighting analysis. Conclusion: HI and LMI statin use is associated with a significant reduction in MACE events than no-statin use. HI statin use wasassociated with better MALE outcomes than no-statin or LMI statin use.

참고문헌 (35)

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