Statin therapy reduces future risk of lower limb amputation in patient with diabetes and peripheral artery disease.

Statin therapy reduces future risk of lower limb amputation in patient with diabetes and peripheral artery disease.

J Clin Endocrinol Metab. 2017 Apr 07;:

Authors: Hsu CY, Chen YT, Su YW, Chang CC, Huang PH, Lin SJ

Abstract
Context: 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.
Objective: To investigate whether the use of statin is associated with a risk reduction in lower extremity amputation in type 2 diabetes (DM) patients with peripheral artery disease (PAD).
Design: Observational cohort study.
Setting: Using 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 3 groups: 11,409 patients were statin-users; 4,430 patients were non-statin lipid lowering agent-users; and 53,493 patients were non-users.
Main Outcome Measures: The primary outcome was lower extremity amputation. Secondary outcomes were in-hospital cardiovascular death and all-cause mortality.
Results: Compared with non-user, statin-users were associated with lower risks of lower extremity amputation (aHR 0.75, 95% CI 0.62-0.90), in-hospital cardiovascular death (aHR 0.78, 95% CI 0.69-0.87), and all-cause mortality (aHR 0.73, 95% CI 0.69-0.77). 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 0.61-0.97) and cardiovascular death (HR 0.78, 95% CI 0.68-0.89) while taking competing risk of death into consideration.
Conclusions: Compared to statin non-users who were never treated with lipid-lowering drugs, this study found that statin users had a lower risk of lower extremity amputation and cardiovascular death in patients with DM and PAD.

PMID: 28398564 [PubMed - as supplied by publisher]

http://ift.tt/2psKvlk