Statin use and functional decline in patients with and without peripheral arterial disease.
OBJECTIVE
We determined whether statin use (vs. non-use) is associated with less annual decline in lower-extremity functioning in patients with and without lower-extremity peripheral arterial disease (PAD) over three-year follow-up.


BACKGROUND
It is unclear whether statin use is associated with less functional decline in patients with PAD.


METHODS
Participants included 332 men and women with an ankle brachial index (ABI) <0.90 and 212 with ABI 0.90 to 1.50. Functional outcomes included 6-min walk distance and usual and rapid-pace 4-m walking velocity. A summary performance score combined performance in walking speed, standing balance, and time for five repeated chair rises into an ordinal score ranging from 0 to 12 (12 = best).


RESULTS
Adjusting for age, race, gender, comorbidities, education, health insurance, total cholesterol/high-density lipoprotein level, body mass index, pack-years of smoking, leg symptoms, immediately previous year functioning, statin use/non-use, ABI, and change in ABI, the PAD participants using statins had less annual decline in usual-pace walking velocity (0.002 vs. -0.024 m/s/year, p = 0.013), rapid-pace walking velocity (-0.006 vs. -0.042 m/s/year, p = 0.006), 6-min walk performance (-34.5 vs. -57.9 feet/year, p = 0.088), and the summary performance score (-0.152 vs. -0.376, p = 0.067) compared with non-users. These associations were attenuated slightly by additional adjustment for high-sensitivity C-reactive protein levels. Among non-PAD participants, there were no significant associations between statin use and functional decline.


CONCLUSIONS
The PAD patients on statins have less annual decline in lower-extremity performance than PAD patients who are not taking statins.
Giri
Jay
J
Massachusetts General Hospital, Boston, Massachusetts, USA.
McDermott
Mary M
MM
Greenland
Philip
P
Guralnik
Jack M
JM
Criqui
Michael H
MH
Liu
Kiang
K
Ferrucci
Luigi
L
Green
David
D
Schneider
Joseph R
JR
Tian
Lu
L
D000368:Aged; D050197:Atherosclerosis / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007866:Leg / Q000098:blood supply* / Q000503:physiopathology*; D008297:Male; D016491:Peripheral Vascular Diseases / Q000188:drug therapy* / Q000503:physiopathology*; D011446:Prospective Studies
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors