Adherence to Statin Therapy Drives Survival of Patients with Symptomatic Peripheral Artery Disease

Login or register to view PDF.
Creative Commons Licence
 
Received date
13 May 2020
Accepted date
13 May 2020
Citation
European Cardiology Review 2020;15:e30.
DOI
https://doi.org/10.15420/ecr.2020.15.1.PO7
Open access
This work is open access under the CC-BY-NC 4.0 License which allows users to copy, redistribute and make derivative works for non-commercial purposes, provided the original work is cited correctly.

Background: Statins reduce cardiovascular morbidity and mortality, but adherence is suboptimal. We hypothesised that adherence to statins determines survival in patients with peripheral artery disease (PAD).

Methods and results: Single centre observational study with 691 symptomatic PAD patients admitted to a tertiary university centre between 2010 and 2017. Mortality was evaluated over a mean follow-up of 50 ┬▒ 26 months. Statin adherence and LDL cholesterol (LDL-C) target attainment was related to total mortality.

Initially, 73% of the patients were on statins with an increase in statin use to 81% (p<0.0001) at follow-up. Statin dosage, normalised to simvastatin 40 mg, increased from 50 to 58 mg/day (p<0.0001), paralleled by a mean decrease of LDL-C from 97 to 82 mg/dl (p<0.0001). The proportion of patients on a high-intensity statin treatment increased over time from 38 to 62% (p<0.0001).

Patients never receiving statins had a higher mortality rate (34%) compared to patients on statins (20%) or having newly received a statin (15%; p<0.01). Moreover, patients on intensified statin medication had the lowest mortality (10%), whereas patients who terminated statin medication or reduced the statin dosage had a higher mortality rate (33% and 43%, respectively; p<0.05).

Conclusion: Statin treatment, particularly high-intensity therapy, reduces mortality in symptomatic PAD. Patients benefit even from de novo statin therapy, whereas dose reduction or statin discontinuation have deleterious effects. A strategy of intensive and sustained statin therapy is worthwhile.

Adherence to Statin Therapy

Open in new tab
Open ppt