Statin therapy has been associated with reductions in the risk of all-cause death, cardiovascular (CV)-related death, and composite adverse limb outcomes of endovascular therapy (EVT) and amputation, according to the results of a study published in JAMA Network Open.
The findings also showed that statin therapy could have protective CV and limb benefits for those with kidney failure and concomitant peripheral artery disease (PAD) who are receiving long-term maintenance dialysis.
Investigators study included 10,767 individuals with kidney failure, concomitant PAD, and dyslipidemia, receiving long-term maintenance dialysis, who met the predetermined criteria. Of those individuals, 3597 individuals were on statin therapy.
The incidence and risk of CV and all-cause death were significantly lower in the statin arm at 18.9% for CV death and 33.3% for all-cause death compared with the non-statin arm at 21.2% and 35.2%, respectively.
The use of statin was associated with lower incidence and risk of the composite adverse limb outcome of EVT and amputation at 9.7% at a 3-year follow up compared with 11.2% for those who were taking a statin.
The results of subgroup analyses were also consistent with the results of the primary analysis across all sub-group variables, the study results showed.
In an adjusted dose-response analysis, investigators saw that the risk reduction associated with statin use increased in a dose-dependent manner for both all-cause death, as well as the composite outcome of EVT and amputation compared with individuals who were not taking a statin.
Investigators reported that not all findings in the study were statistically significant.
The primary outcomes of the study included all-cause death and the composite of endovascular therapy. The other outcomes included CV events, including death, acute myocardial infraction, ischemic stroke, and hospitalization for heart failure, major adverse limb events, and all-cause readmission.
Investigators examined the outcomes at 1 and 3 years. They also used a propensity score to match individuals 1-to-1 among those receiving statin therapy and those who did not receive statin therapy.
Furthermore, the investigators used a defined-daily-dose approach to evaluate whether the association of statin therapy and the risk of primary outcomes was dose-dependent.
Investigators compiled data from the Taiwan National Health Insurance Research Database and included individuals between January 1, 2001, and December 31, 2013. The data were analyzed between June 8, 2021, and June 2, 2022.
Limitations of the study included a lack of details regarding disease severity and symptoms, and the behavior of individuals could not be assessed using that data. Therefore, investigators could not see adherence to treatment, but they did say that this limitation would be inevitable because data was from real-world cohort studies.
further studies are needed to determine the benefits of statin therapy across individuals with different symptom severity and how it varies, investigators said.
Lo H, Lin Y, Lin DS, Lee J, Chen W. Association of statin therapy with major adverse cardiovascular and limb outcomes in patients with end-stage kidney disease and peripheral artery disease receiving maintenance dialysis. JAMA Netw Open. 2022;5(9):e2229706. doi:10.1001/jamanetworkopen.2022.29706