Statin therapy and long-term adverse limb outcomes in patients with peripheral artery disease: insights from the REACH registry
Open accessAbstract
AIMS: Due to a high burden of systemic cardiovascular events, current guidelines recommend the use of statins in all patients with peripheral artery disease (PAD). We sought to study the impact of statin use on limb prognosis in patients with symptomatic PAD enrolled in the international REACH registry. METHODS: Statin use was assessed at study enrolment, as well as a time-varying covariate. Rates of the primary adverse limb outcome (worsening claudication/new episode of critical limb ischaemia, new percutaneous/surgical revascularization, or amputation) at 4 years and the composite of cardiovascular death/myocardial infarction/stroke were compared among statin users vs. non-users. RESULTS: A total of 5861 patients with symptomatic PAD were included. Statin use at baseline was 62.2%. Patients who were on statins had a significantly lower risk of the primary adverse limb outcome at 4 years when compared with those who were not taking statins [22.0 vs. 26.2%; hazard ratio (HR), 0.82; 95% confidence interval (CI), 0.72-0.92; P = 0.0013]. Results were similar when statin use was considered as a time-dependent variable (P = 0.018) and on propensity analysis (P < 0.0001). The composite of cardiovascular death/myocardial infarction/stroke was similarly reduced (HR, 0.83; 95% CI, 0.73-0.96; P = 0.01). CONCLUSION: Among patients with PAD in the REACH registry, statin use was associated with an ∼18% lower rate of adverse limb outcomes, including worsening symptoms, peripheral revascularization, and ischaemic amputations. These findings suggest that statin therapy not only reduces the risk of adverse cardiovascular events, but also favourably affects limb prognosis in patients with PAD.
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In the REACH registry, statin use was associated with about an 18% lower rate of adverse limb outcomes.
“in the Reduction of Atherothrombosis for Continued Health (REACH) registry, statin use was associated with an ~18% lower rate of adverse limb outcomes.408”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [408]
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- Authors
- Kumbhani, D. J., Steg, P. G., Cannon, C. P., Eagle, K. A., Smith, S. C., Goto, S., Ohman, E. M., Elbez, Y., Sritara, P., Baumgartner, I., Banerjee, S., Creager, M. A., & Bhatt, D. L.
- Affiliations
- The University of Texas Southwestern Medical Center (US)
- Brigham and Women's Hospital (US)
- University of Michigan (US)
- University of North Carolina at Chapel Hill (US)
- Tokai University (JP)
- Duke University (US)
- Inserm (FR)
- Mahidol University (TH)
- Corresponding author
- Kumbhani, Dharam J.
- ORCID
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-02-28
- Volume
- 35
- Issue
- 41
- Pages
- 2864-2872
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- PMC
- PMC4216432
- OpenAlex
- W2160694670
- Cited by
- 318
- References
- 42
- Citations by year
- 2026: 12 · 2025: 24 · 2024: 22 · 2023: 19 · 2022: 28 · 2021: 40 · 2020: 36 · 2019: 26 · 2018: 38 · 2017: 27 · 2016: 25 · 2015: 14 · 2014: 6 · 2013: 1
- FWCI
- 23.76
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Heart Journal (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- reroDoc Digital Library (submittedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
- Keywords
- statin therapy, peripheral arterial disease, critical limb ischemia, amputation, revascularization, claudication, cardiovascular events, REACH registry
- MeSH terms
- Aged, Coronary Artery Disease, Extremities, Female, Humans, Intermittent Claudication, Ischemia, Male, Physician's Role, Registries, Treatment Outcome, Disease Progression, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Peripheral Arterial Disease
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