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.