open access
Is rosuvastatin better than atorvastatin and simvastatin in the prevention of in-stent restenosis and atherosclerosis progression in patients after superficial femoral artery stenting due to chronic lower limb ischaemia? The preliminary case-control study
open access
Abstract
Introduction. Statins effect on the outcome of endovascular intervention due to chronic lower limb ischaemia (CLLI) is still uncertain. The aim of this study was to determine the effect of statin type on the late outcome of superficial femoral artery (SFA) stenting in patients with CLLI.
Material and methods. Retrospective analysis of the medical documentation of 275 consecutive patients treated with SFA stenting due to CLLI, including 125 (45%) patients with critical limb ischaemia (CLI). Measured outcomes were: target lesion revascularization (TLR), target extremity revascularization (TER), and target limb amputation (TLA).
Results. Statins were used by 267 (97%) of the patients, respectively: atorvastatin (n = 191, 70%), simvastatin (n = 31, 11%) and rosuvastatin (n = 45, 16%). During the 675.0 ± 569.7 days of follow-up, TLR was required by 79 (29%) patients, TER by 109 (39%), and TLA by 27 (10%). Patients treated with rosuvastatin in comparison with those treated with atorvastatin, in spite of greater initial LDL and triglyceride levels, required TER (p = 0.01) and TLR (p = 0.03) less frequently. The risk of TER in patients treated with rosuvastatin was significantly (p = 0.016) lower than in individuals treated with atorvastatin and simvastatin, as shown in the Kaplan-Meier analysis. Cox’s proportional hazards regression showed that therapy with rosuvastatin was the strongest factor (HR 0.40 ± 95% CI; 0.2-0.81) decreasing the likelihood of TER.
Conclusions. Rosuvastatin after SFA stenting seems to have the strongest effect on reduction in reintervention risk but without influence on limb salvage.
Abstract
Introduction. Statins effect on the outcome of endovascular intervention due to chronic lower limb ischaemia (CLLI) is still uncertain. The aim of this study was to determine the effect of statin type on the late outcome of superficial femoral artery (SFA) stenting in patients with CLLI.
Material and methods. Retrospective analysis of the medical documentation of 275 consecutive patients treated with SFA stenting due to CLLI, including 125 (45%) patients with critical limb ischaemia (CLI). Measured outcomes were: target lesion revascularization (TLR), target extremity revascularization (TER), and target limb amputation (TLA).
Results. Statins were used by 267 (97%) of the patients, respectively: atorvastatin (n = 191, 70%), simvastatin (n = 31, 11%) and rosuvastatin (n = 45, 16%). During the 675.0 ± 569.7 days of follow-up, TLR was required by 79 (29%) patients, TER by 109 (39%), and TLA by 27 (10%). Patients treated with rosuvastatin in comparison with those treated with atorvastatin, in spite of greater initial LDL and triglyceride levels, required TER (p = 0.01) and TLR (p = 0.03) less frequently. The risk of TER in patients treated with rosuvastatin was significantly (p = 0.016) lower than in individuals treated with atorvastatin and simvastatin, as shown in the Kaplan-Meier analysis. Cox’s proportional hazards regression showed that therapy with rosuvastatin was the strongest factor (HR 0.40 ± 95% CI; 0.2-0.81) decreasing the likelihood of TER.
Conclusions. Rosuvastatin after SFA stenting seems to have the strongest effect on reduction in reintervention risk but without influence on limb salvage.
Keywords
chronic lower limb ischaemia, statins, endovascular therapy, superficial femoral artery stenting, reintervention risk, amputation risk
About this articleTitle
Is rosuvastatin better than atorvastatin and simvastatin in the prevention of in-stent restenosis and atherosclerosis progression in patients after superficial femoral artery stenting due to chronic lower limb ischaemia? The preliminary case-control study
Journal
Issue
Article type
Research paper
Pages
5-11
Published online
2016-09-29
Page views
851
Article views/downloads
1301
DOI
Bibliographic record
Acta Angiologica 2016;22(1):5-11.
Keywords
chronic lower limb ischaemia
statins
endovascular therapy
superficial femoral artery stenting
reintervention risk
amputation risk
Authors
Jacek Budzynski
Joanna Kubiak
Grzegorz Pulkowski
Karol Suppan
Marcin Wasielewski
Joanna Wisniewska
Radoslaw Wieczor