statin reduces amputation risk in DM PAD

What is it about?

Although there is evidence to support the beneficial effects of statins on major cardiovascular events, few studies address the protection effect of statins on limb outcome. In addition, there is scant clinical data to support the advantages of statins over other lipid-lowering agents on peripheral artery disease (PAD) outcome. By using nationwide diabetic cohort data consisting of 1.2 million patients representing the majority of the diabetic population in Taiwan from 2000 to 2011, we aimed to investigate whether the use of statins reduces lower extremity amputation rate in a high risk population with known PAD as compared to two propensity score-matched cohorts without statin use (including non-statin lipid lower agents group, and non-user group) while taking into consideration the competing risk of death. In our results, compared with non-user, both statin user and non-statin lipid-lowering agent user were associated with a lower risk of all-cause mortality. However, only statin users were associated with the risk reduction of lower extremities amputation and cardiovascular death after propensity score-matched analysis.

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Why is it important?

Among diabetic patients with PAD, statin therapy was associated with an approximately 25% lower rate of lower extremity amputations, in addition to a 22% risk reduction of cardiovascular mortality while taking into consideration the competing risk of death. These findings suggest that statin therapy not only reduces the risk of adverse cardiovascular events, but also has favorably affects of limb prognosis in diabetic patients with PAD.

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