Author + information
- Wonho Kim1,
- Young-Guk Ko2,
- Pil-Ki Min3,
- Jae-Hwan Lee4,
- Cheol Woong Yu5,
- Sang-Rok Lee6,
- Seung Hyuk Choiu7,
- In-Ho Chae8 and
- Donghoon Choi9
- 1Eulji University Hospital, Daejeon, Korea, Republic of
- 2Divisions of Cardiology, Departments of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of
- 3Gangnam Severance Hospital, Seoul, Korea, Republic of
- 4Chungnam National University Hospital, Daejeon, Korea, Republic of
- 5Korean University Anam Hospital, Seoul, Korea, Republic of
- 6Chonbuk National University, Jeonju, Korea, Republic of
- 7Samsung Medical Center, Seoul, Korea, Republic of
- 8Seoul National University Bundang Hospital, Seonganmsi, Korea, Republic of
- 9Division of Cardiology, Departments of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of
There is a paucity of data on the effect of statin therapy on clinical outcomes after endovascular treatment (EVT), especially in patients with femoropopliteal (FP) artery disease. We therefore examined associations between statin use and mortality, myocardial infarction (MI), stroke and reintervention in patients with FP artery disease.
A total of 1493 patients with 1809 limbs were analyzed from the K-VIS ELLA registry data. The primary end point was the cumulative incidence of mortality (all-cause and cardiovascular) during 2 year follow-up. Secondary end points were the cumulative incidence of stroke, myocardial infarction, and reintervention. To adjust baseline potential confounders, a propensity score matching (PSM) was used.
The patients were divided into 2 groups according to the use of statins (the statin group, n=1262 and the non-statin group, n=547). After PSM, baseline characteristics of both groups were balanced. During a 2-year follow-up, the statin group had lower cumulative incidence of all-cause mortality compared with the non-statin group (7.8 % vs 15.0 %, log rank, p-value < 0.001 and 7.0 % vs 14.4 %, log rank, p-value = 0.006 after PSM). In addition, there was statistically significant difference in the cumulative incidence of cardiovascular mortality (2.3 % vs 5.3 %, log rank, p-value=0.010) in the unmatched cohort. However, it was not reach statistical significance after PSM in both groups. The cumulative incidences of MI, stroke and reintervention in both groups were similar before and after PSM. Statin therapy was a strong negative predictor of all-cause mortality on univariate analysis (0.474, 95% CI 0.333 to 0.674, p-value< 0.001) and multivariate analysis (0.554, 95% CI 0.385 to 0.796, p-value < 0.001).
|*;p-value < 0.001||Before matching||After matching|
|statin group (n=1026)||non-statin group (n=464)||Statin group (n=328)||Non-statin group (n=328)|
|All cause mortality|
|1 year||50 (5.3 %)||47 (10.9 %) *||16 (5.3 %)||30 (10.0 %) *|
|2 years||66 (7.8 %)||58 (15.0 %) *||19 (5.7 %)||38 (14.0 %)*|
|1 year||14 (1.5 %)||12 (2.8 %) *||4 (1.4 %)||6 (2.1 %)|
|2 years||19 (2.3 %)||18 (5.3 %) *||5 (1.9 %)||11 (5.1 %)|
|AMI||10 (2.0 %)||3 (2.0 %)||4 (1.5 %)||1 (0.7 %)|
|Reintervention||180 (18.0 %)||67 (17.5 %)||41 (15.1 %)||47 (19.5 %)|
Statin therapy after EVT in patients with FP artery disease is associated with promising clinical outcome, in terms of the decreased mortality.
ENDOVASCULAR: Peripheral Vascular Disease and Intervention