Statin Therapy Reduces Future Risk of Lower-Limb Amputation in Patients With Diabetes and Peripheral Artery Disease

Lowering cholesterol has been important for a while now. It not just prevents heart disease, it can also lower your stroke risk.

There are those that use supplements as a way to lower cholesterol, but statins remain the gold standard in management.

Preamble: Although there is evidence to support the beneficial effects of statins on major cardiovascular events, few studies address the protective effect of statins on limb outcome.

Hsu CY et al. aimed to investigate whether the use of statin is associated with a risk reduction in lower extremity amputation in type 2 diabetes mellitus (DM) patients with peripheral arterial

disease (PAD).

Design: Observational cohort study.

Setting: A nationwide DM database in Taiwan from 2000 to 2011.

Patients: A total of 69,332 patients aged ≥ 20 years with DM and PAD were identified.

Intervention: Patients were divided into three groups: 11,409 patients were statin users, 4430 patients used non-statin lipid-lowering agents, and 53,493 patients were nonusers.

Main Outcome Measures: The primary outcome was lower-extremity amputation. Secondary outcomes were in-hospital cardiovascular death and all-cause mortality.

Results:

·    Compared with nonusers, statin users were associated with lower risks of lower-extremity amputation [adjusted hazard ration (aHR), 0.75; 95% confidence interval (CI), 0.62 to 0.90], in hospital cardiovascular death(aHR, 0.78; 95% CI, 0.69 to 0.87), and all-cause mortality (aHR, 0.73; 95% CI, 0.69 to 0.77).

·    In the propensity score matching analysis, the effect of statin on the risk of lower-extremity amputation was consistent. Only statin users were associated with the risk reduction of lower-extremities amputation (HR, 0.77; 95% CI, 0.61 to 0.97) and cardiovascular death (HR, 0.78; 95% CI, 0.68 to 0.89) when taking competing risk of death into consideration.

The authors concluded that compared with statin nonusers who were never treated with lipid-lowering drugs, statin users had a lower risk of lower-extremity amputation and cardiovascular death in patients with DM and PAD.

What Is Your Heart Disease Risk? Heart Doctor Vivek Baliga Discusses..

Heart disease affects millions of people across the globe. These days, one of the most common reasons why young people visit doctors is not just for the common cold or flu, but also to find out what their chances of developing heart disease are.

Years ago, a group of researchers started looking into whether an individual’s risk of developing heart disease could be estimated. 

Looking at normal parameters such as high blood pressure, diabetes, heart disease in the family and a history of high cholesterol and smoking were all well and good, but there was no way to know what exactly a person’s risk was in years to come.

In 1946, scientists embarked on the Framingham Heart Study. 

This remains, to date, one of the largest heart studies performed all over the world. This study was so robust and remarkable, that to this day we use data published from this to determine an individual’s heart disease risk. 

Not only that, the study also provided valuable insights into how various risk factors affect the heart and how one can make changes to reduce their risk.

The risk scoring system takes into account various parameters including age and gender, and churns out a 10 year risk score. 

This risk score determines what a person’s chances are of having a heart attack in 10 years time. 

Those who have a low risk score have a 10% chance of heart disease in 10 years, those with an intermediate risk score have a 10 – 20 % risk while those with a high risk score have a >20% risk.

Since the Framingham risk score emerged, a number of different scoring systems are being used not only to predict chances of developing heart disease, but also outcomes of patients following a heart attack. 

The Q-risk score is being used more widely these days. Similarly, the GRACE score and CHADS2VASc scoring systems are also used for patients with heart disease.

It must be remembered that these scoring systems are arbitrary. They apply to majority of individuals but not to all. Ask your doctor about what your heart disease risk is today.