title: Attainment of low-density lipoprotein cholesterol goal after endovascular treatment is associated with reduced cardiovascular events in patients with peripheral arterial disease.
abstract: OBJECTIVE
  The relationship between attainment of low-density lipoprotein cholesterol (LDL-C) levels and clinical outcomes in patients with peripheral arterial disease (PAD) has received little attention. We sought to investigate clinical outcomes in relation to attainment of LDL-C goals in patients with PAD after endovascular treatment.
  
  
  METHODS
  We reviewed 342 PAD patients treated with endovascular therapy from 2010 through 2012. We categorized patients into two groups based on the attained LDL-C levels at short-term follow-up (mean, 4.8 ± 2.8 months): group A (n = 160), with LDL-C <70 mg/dL; and group B (n = 182), with LDL-C ≥70 mg/dL. The primary end point was major adverse cardiovascular events (MACEs), a composite of all-cause death, nonfatal myocardial infarction, and stroke.
  
  
  RESULTS
  Baseline characteristics were similar between group A and group B except for obstructive pulmonary disease (0% vs 7%; P = .001). More patients in group A received statin therapy than those in group B (93% vs 76%; P < .001). MACEs (4% vs 10%; P = .002) and all-cause mortality (2% vs 7%; P = .007) occurred less frequently in group A than in group B at 2 years. A Cox proportional hazards multivariate regression model identified attainment of LDL-C goal <70 mg/dL at short-term follow-up as an independent predictor of reduced MACEs (hazard ratio, 0.25; 95% confidence interval, 0.09-0.67; P = .006) along with age as a predictor of increased MACEs (hazard ratio, 1.04; 95% confidence interval, 1.00-1.08; P = .031).
  
  
  CONCLUSIONS
  Attainment of LDL-C goal <70 mg/dL at short-term follow-up is an independent predictor of reduced mortality and cardiovascular events after endovascular therapy in patients with PAD.
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jung-Hee
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea; Cardiovascular Institute, Yonsei University College of Medicine, Seoul, Korea. Electronic address: ygko@yuhs.ac.
authors.forename: Young-Guk
authors.initials: YG
authors.lastname: Ko
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea; Cardiovascular Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Dong-Ho
authors.initials: DH
authors.lastname: Shin
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea; Cardiovascular Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jung-Sun
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea; Cardiovascular Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Byeong-Keuk
authors.initials: BK
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea; Cardiovascular Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea; Cardiovascular Institute, Yonsei University College of Medicine, Seoul, Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Myeong-Ki
authors.initials: MK
authors.lastname: Hong
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea; Cardiovascular Institute, Yonsei University College of Medicine, Seoul, Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D016009:Chi-Square Distribution; D008078:Cholesterol, LDL / Q000097:blood*; D018572:Disease-Free Survival; D050171:Dyslipidemias / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058729:Peripheral Arterial Disease / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors