PAD Patients Less Likely to Receive Statins, Despite Increased Cardiac Event Risk: Study

India: A retrospective study published in the Journal of the Association of Physicians of India revealed that patients with Peripheral Arterial Disease (PAD) are often underprescribed to appropriate statin therapy, even though they are at high risk for future cardiac events. 

The study found that the involvement of more vascular beds increased the likelihood of initiating high-intensity statin therapy. The findings highlight the need for greater awareness among healthcare providers to start high-intensity statin treatment in PAD patients, regardless of cholesterol levels, similar to the approach used for acute coronary syndrome (ACS) patients.

Atherosclerotic cardiovascular disease (ASCVD) events are frequent in patients with PAD, which impacts over 202 million individuals globally. Previous research has indicated that statin use among PAD patients remains low.

Given this context, Shweta Agrawal, Associate Professor, Department of Cardiology, St. John’s Medical College Hospital, Bengaluru, Karnataka, India et. al. aimed to assess the proper use of statins in PAD patients and examine statin usage among those with PAD and involvement in other vascular beds.

To conduct this retrospective cross-sectional study, researchers reviewed data from patients with a confirmed PAD diagnosis based on invasive or noninvasive imaging. Demographic, clinical, laboratory, and treatment information was summarized using descriptive statistics. Multiple logistic regression analysis was performed to identify predictors for prescribing high-intensity statins. According to American College of Cardiology and American Heart Association guidelines, high-intensity statin therapy was defined as atorvastatin ≥40 mg per day, rosuvastatin ≥20 mg per day, or simvastatin ≥80 mg per day.

The key findings of the research were as follows:

• Statins were used by 82% of patients; however, only 39% were on high-intensity statins.
• Patients with cerebrovascular disease (CVD) had lower odds of receiving lower extremity revascularization (LIS) therapy, with an odds ratio of 0.19).
• Those on oral anticoagulants (OAC) also had lower odds of receiving LIS therapy (OR = 0.16).
• Patients on dual antiplatelet therapy (DAPT) were less likely to receive LIS therapy (OR = 0.20).

The researchers concluded that patients with PAD are less likely to receive appropriate statin therapy, despite having a high risk of future adverse cardiac events. Involvement of more vascular beds was associated with higher chances of initiating high-intensity statin.

Reference

Agrawal S, Batta SA, Kamath D, et al. Statin Usage in Peripheral Arterial Disease Patients. J Assoc Physicians India 2024;72(6):54-56.