Peripheral Arterial Disease: Effect of Statin Therapy and Dose on CV and Limb Outcomes

Pavankumar Kamat


August 31, 2021


  • In patients with peripheral arterial disease (PAD), statin therapy was associated with a lower risk of all-cause mortality (ACM), major adverse cardiac events (MACE), cardiovascular mortality (CVM) and amputations.

  • Higher doses of statins showed a significant improvement in ACM, CVM and amputations.

Why this matters

  • Findings strengthen the evidence for the protective effects of statin use in PAD, while also supporting the effectiveness of higher doses in preventing detrimental patient outcomes.

Study design

  • UK researchers performed a meta-analysis of 24 studies (n=268,611).

  • Primary outcomes: ACM and major lower limb amputation.

  • Secondary outcomes: CVM and MACE (non-fatal cerebrovascular accident, myocardial infarction and CV death).

  • Funding: None.

Key results

  • Statin therapy vs no statins was significantly associated with a lower risk of:

    • ACM (OR, 0.68; 95% CI, 0.60-0.76; I2, 56% and HR, 0.74; 95% CI, 0.70-0.78; P<.001 for both);

    • MACE (OR, 0.84; 95% CI, 0.78-0.92; P<.001 and HR, 0.78; 95% CI, 0.65-0.93);

    • amputations (HR, 0.64; 95% CI, 0.53-0.78; P<.001; I2, 81%); and

    • CVM (OR, 0.55; 95% CI, 0.38-0.78; P=.001; I2, 90%).

  • High-dose statin therapy was significantly associated with a lower risk of (HR; 95% CI):

    • ACM (0.74; 0.62-0.89; P=.001; I2, 76%);

    • CVM (0.71; 0.63-0.80); and

    • amputations (0.78; 0.69-0.90).

  • High-dose statin therapy was not significantly associated with a reduced risk of MACE (OR, 0.77; 95% CI, 0.49-1.21).


  • Heterogeneity among studies.


Sofat S, Chen X, Chowdhury MM, Coughlin PA. Effects of Statin Therapy and Dose on Cardiovascular and Limb Outcomes in Peripheral Arterial Disease: A Systematic Review and Meta-analysis. Eur J Vasc Endovasc Surg. 2021 Aug 10 [Epub ahead of print]. doi: 10.1016/j.ejvs.2021.05.025. PMID: 34389230.  View abstract 

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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