title: Lowered LDL-C Levels Reduce Later Local Vascular Events after Surgical or Endovascular Treatment of Peripheral Artery Disease.
abstract: OBJECTIVE
  To examine the relationship between incidence of later, local vascular events (restenosis and occlusion) and clinical factors including lipid levels after surgical or endovascular treatment of peripheral artery disease (PAD).
  
  
  METHODS
  Consecutive 418 PAD lesions (in 308 patients under the age of 70) treated with surgical (n = 188) or endovascular (n = 230) repair for iliac (n = 228) and infrainguinal (n = 190) lesions were retrospectively analyzed. Clinical features and lipid levels were compared between patients who developed vascular events (n = 51; VE group) and those who did not (n = 257; NoVE group).
  
  
  RESULTS
  Among assessed factors, post-therapeutic low-density lipoprotein cholesterol (LDL-C) levels (mg/dL) were significantly higher in the VE group (120.4 ± 31.2) than in the NoVE group (108.2 ± 25.1) (P = 0.01). Infrainguinal lesions were more common in the VE than in the NoVE group (P <0.001). Cox hazard analysis indicated that infrainguinal lesions relative to iliac lesions significantly increased the risk of vascular events (hazard ratio (HR) 3.35; 95% CI 1.63-6.90; P = 0.001) and post-therapeutic LDL-C levels <130 (mg/dL) decreased the risk (HR 0.34; 95%CI 0.17-0.67; P = 0.002).
  
  
  CONCLUSIONS
  Lowered post-therapeutic LDL-C levels can decrease the risk of later, local vascular events after PAD treatment. These results may support the rationale for aggressive lipid-modifying therapy for PAD.
authors.affiliation: Division of Cardiovascular Surgery, Aishin Memorial Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Kouji
authors.initials: K
authors.lastname: Ishii
authors.forename: Junichiro
authors.initials: J
authors.lastname: Takahashi
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kanaoka
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Wakamatsu
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Gohda
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Sasaki
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Matsui
keywords: LDL-C; PAD; dyslipidemia; endovascular treatment; surgical treatment
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