In the study, 22,208 patients (average age 71.1 years) with PAOD were identified via health insurance claims data. Patients had undergone revascularization between 2008 and 2018, had no history of statin therapy, and received at least one antithrombotic medication in the first quarter after discharge. After propensity matching, 2,112 patients with chronic limb-threatening ischemia were included in each group: new statin users and nonusers. Additionally, patients were further categorized as having intermittent claudication or chronic limb-threatening ischemia.
The efficacy outcomes for this study included all-cause mortality, CV events (myocardial infarction, stroke, transient ischemic stroke), and incident major amputation. The safety outcomes of the study included incident diabetes mellitus and myopathy. The researchers noted that in patients with chronic limb-threatening ischemia, statin initiation was associated with lower all-cause mortality (hazard ratio [HR], 0.75; 95% CI, 0.68–0.84), lower risk for major amputation (HR, 0.73; 95% CI, 0.58–0.93), and reduced risk for CV events (HR, 0.80; 95% CI, 0.70–0.92) during the 5-year follow-up. In patients with intermittent claudication, statin initiation was correlated with a diminished risk for all-cause mortality (HR, 0.80; 95% CI, 0.70–0.92) and lower risk for CV events (HR, 0.80; 95% CI, 0.70–0.92).
The researchers concluded that initiating statin therapy in patients with PAOD after index revascularization is effective and safe with an outcome size analogous to earlier studies. They noted that their data documented expanded long?term survival and freedom from amputation and CV events for starting statin therapy after revascularization. Moreover, the authors indicated that safety concerns about the onset of diabetes mellitus and myopathy could not be verified, and their results show that new recipients of statin therapy benefit as much as common users, highlighting the significance of quality improvement and awareness campaigns to expand prescription rates.
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