Abstract 10777: Statins Bring the Prognostic Impact Only in Peripheral Artery Disease Patients With Elevated C-reactive Proteins

Introduction:Recent trials demonstrated favorable effects of statins on the clinical prognosis, partly through anti-inflammatory properties, in patients with coronary artery disease. However, this favorable effect has not been fully verified in patients with peripheral arterial disease (PAD). We hypothesized that statins exert different prognostic effects depending on the degrees of inflammation at the time of endovascular therapy (EVT).Methods:This study initially included 628 consecutive PAD patients who underwent EVT. After the exclusion of patients without information of C-reactive protein (CRP) at the time of index EVT, 560 patients including 285 statin users and 275 statin non-users were ultimately analyzed. The patient enrolled were divided into 4 categories depending on CRP level at the time of EVT; Low-CRP (<0.1 mg/dL), Intermediate-low-CRP (0.1-0.3 mg/dL), Intermediate-High-CRP (0.3-1.0 mg/dL), and High-CRP (>1.0 mg/dL). A composite of death and major amputation as the primary endpoint of this study was retrospectively compared between statin users and non-users in each CRP category.Results:The composite endpoint occurred in 124 patients during the observation period. Overall, statin users had a significantly lower event rate than non-users (Log-rank test: P=0.002). However, there were no significant difference in the event rates between statin users and non-users in the Low-, Intermediate-Low, and Intermediate-High-CRP categories. Only in the High-CRP category, statin users showed a significantly lower event rate than non-users (P=0.002, Figures). Multivariate Cox regression analysis revealed that statin use was independently associated with the primary endpoint (adjusted hazard ratio: 0.28 [95% confidence interval: 0.14-0.55]), even after the adjustment of covariants.Conclusion:Statins may exert a favorable prognostic effect in PAD patients with highly elevated CRP, but not in those with low to moderate CRP level.