144 - Statins reduce major adverse limb events and mortality in patients with peripheral artery disease. (ID 816)
Abstract
Background and Aims
Statins are guideline recommended in patients with peripheral artery disease (PAD) for prevention of cardiovascular events. However, comprehensive meta-data on the impact of statin therapy on major adverse limb events (MALE) in PAD patients have not been reported. We want to investigate the association of statin use with MALE events, all-cause death, cardiovascular death and stroke in these patients.
Methods
We performed a systematic review and meta-analysis by searching PubMed (via MEDLINE) and Cochrane (CENTRAL) databases for clinical studies addressing the impact of statin therapy on different outcomes. The main outcomes were MALE, all-cause death, cardiovascular death and stroke.
Results
We included 51 studies with 138,060 PAD patients, of whom 48,459 (35.1%) were treated with statins. The studies included 2 randomized controlled trials, 20 prospective and 29 retrospective cohorts studies. Overall, 11,396 MALE events, 21,624 deaths, 4,609 cardiovascular deaths, and 860 strokes were used for the analysis. Statins reduced the incidence of MALE by 30% (pooled Hazard Ratio [pHR] 0.702, 95% Confidence Interval [CI] 0.605-0.815), amputations by 35% (HR 0.654, 95%CI 0.522-0.819), all-cause mortality by 39% (pHR 0.608, 95% CI 0.543-0.680), cardiovascular death by 41% (HR 0.594, 95%CI 0.455-0.777) and ischemic stroke by 28% (pHR 0.718, 95%CI 0.620-0.831). Sex, age, diabetes and length of follow-up were not significant predictors for MALEs and mortality at meta-regression analysis.
Conclusions
Statins reduce the incidence of MALE, all-cause and CV mortality in patients with PAD. In PAD patients, a high proportion of MALE events and deaths could be prevented by implementing a statin prescription.
