Serum Low-Density Lipoprotein Cholesterol Level After Endovascular Therapy in Patients With Claudication.
J Endovasc Ther
; 26(3): 402-410, 2019 06.
Article
em En
| MEDLINE
| ID: mdl-30873910
ABSTRACT
PURPOSE:
To investigate the association between low-density lipoprotein cholesterol (LDL-C) levels and the 5-year cardiovascular death rate after endovascular therapy (EVT) in patients with lower limb peripheral artery disease (PAD) according to statin therapy status.METHODS:
From January 2010 to March 2016, 1324 PAD patients (1670 limbs) with claudication (Rutherford category 1-3) underwent EVT. After excluding 389 patients owing to death or missing data, 935 (70.6%) patients (mean age 72.1±8.7 years; 708 men) were included in the analysis. Statin therapy was prescribed to 509 (54.4%) patients at discharge. LDL-C levels at 3 to 6 months after EVT were correlated with the incidence of cardiovascular death (CVD; procedure-related and proximate cardiac, noncoronary vascular, or unknown causes) at 5 years. A stratifying factor of 100 mg/dL was based on the median LDL-C value (94 mg/dL) in the cohort. Predictors of CVD were sought in multivariate analysis; results are presented as the hazard ratio (HR) and 95% confidence interval (CI).RESULTS:
Over a median follow-up of 30.7 months (interquartile range 13.7, 47.6), CVD occurred in 83 (8.9%) patients. The incidence of CVD at 5 years was significantly higher in patients with LDL-C ≥100 mg/dL at 3 to 6 months than in those with LDL-C <100 mg/dL (23.5% vs 13.5%, p=0.03). In addition, LDL-C ≥100 mg/dL at 3 to 6 months was associated with a higher incidence of CVD (25.2% vs 10.9%, p=0.02) in 509 (54.4%) patients with statin therapy at discharge. In the multivariate model, LDL-C ≥100 mg/dL at 3 to 6 months after EVT was an independent predictor of CVD (adjusted HR 1.60, 95% CI 1.001 to 2.59, p=0.049).CONCLUSION:
LDL-C ≥100 mg/dL at 3 to 6 months after the EVT for symptomatic lower limb PAD was independently associated with a higher risk of CVD, particularly in patients on statin therapy at discharge. This observation suggests that intensive LDL-C-lowering therapy may be needed to improve clinical outcomes.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Dislipidemias
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Doença Arterial Periférica
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Procedimentos Endovasculares
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Claudicação Intermitente
/
LDL-Colesterol
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
/
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Aged80
/
Female
/
Humans
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Male
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article