Influence of Preprocedural Statin Usage on Primary Patency and Amputation in Patients Undergoing Lower Limb Peripheral Angioplasty

Abstract

Peripheral arterial disease can progress to critical limb ischemia, which is associated with high amputation rates and requires revascularization. The endovascular approach has lower long-term patency because of restenosis due to neointimal hyperplasia. Statins are significantly advantageous for patients undergoing percutaneous interventions; however, only few studies have reported surgical improvements with statin therapy after endovascular treatment in such patients. This retrospective cohort study assessed the effects of preprocedural statins on lower limb arterial angioplasty outcomes by evaluating patency and amputation rates and comparing with those without statins. Patients who underwent percutaneous transluminal angioplasty of the lower limbs for critical ischemia of the lower limbs or for limiting claudication were included in this retrospective cohort study. Patients were categorized according to statin use prior to and during hospitalization. Patient demographics, lesion morphology, primary patency, and limb salvage rates were compared between these groups. Statistical analyses were performed using Kaplan-Meier and multivariate regression analysis. A total of 178 patients undergoing endovascular intervention by critical ischemia or limiting claudication were included. Approximately 80% of the procedures were ballon angioplasty. Primary patency was 73% in 1year and preprocedural statin usage was not associated with improved primary patency rates (P=0.2798). After adjusting the amputation outcomes for pre-established variables, such as prehospitalization statin use, diabetes, procedure indication, disease location, Trans-Atlantic Inter-Society Consensus classification, and current smoking, there was no statistically significant difference associated with preprocedural statin use in primary patency (hazard ratio: 0.87 [0.33-2.29], P=0.79) or amputation (hazard ratio: 0.70 [0.40-1.23], P=0.22). The use of preprocedural statin did not improve primary patency or amputation rates in patients undergoing peripheral angioplasty.