Lipid-lowering therapy is effective in reducing cardiovascular mortality and morbidity in people with PAD .
It may also improve local symptoms .
Until further evidence on the relative effectiveness of different lipid-lowering agents is available , use of a statin in people with PAD and a blood cholesterol level > /=3.5 mmol/litre is most indicated
BACKGROUND Lipid-lowering therapy is recommended for secondary prevention in people with coronary artery disease .
It may also reduce cardiovascular events and /or local disease progression in people with lower limb peripheral arterial disease ( PAD ) .
OBJECTIVES To assess the effects of lipid-lowering therapy on all-cause mortality , cardiovascular events and local disease progression in patients with PAD of the lower limb .
Effects of Probucol versus Aspirin and versus Brachytherapy on Restenosis after Femoropopliteal Angioplasty: The PAB Randomized Multicenter Trial
Purpose : To evaluate the effect of probucol and /or of endovascular brachytherapy ( EVBT ) on restenosis after percutaneous transluminal angioplasty ( PTA ) of femoropopliteal arteries . Methods : A total of 335 patients ( 206 men ; mean age 72±9 years ) with intermittent claudication were r and omized according to a 2 × 2 factorial design to 1 of the 4 groups : probucol , placebo , EVBT , and EVBT+probucol . Probucol ( 1 g/d ) or placebo were given in double-blinded fashion 1 month before and for 6 months after PTA . Gamma irradiation ( 192Iridium , 14 Gy , 5-mm reference depth ) was r and omly applied in an unblinded manner from a noncentered endoluminal catheter . All patients received aspirin ( 100 mg/d ) . Primary endpoint was restenosis ( > 50 % diameter reduction ) detected by duplex ultrasound 6 months after PTA . Secondary endpoints included clinical and hemodynamic assessment . Results : Restenosis in patients undergoing EVBT was 17 % ( 23/133 ) versus 35 % ( 50/142 ) in patients without EVBT ( p<0.001 ) ; in patients treated with probucol versus placebo , the rates were 23 % ( 31/135 ) and 30 % ( 43/140 , p<0.001 ) . Three quarters ( 77 % , 102/133 ) of patients were free of claudication after EVBT therapy versus 61 % ( 87/142 ) without EVBT ( p<0.05 ) . Need for target vessel revascularization was 6 % ( 8/133 ) with EVBT versus 14 % ( 20/142 ) without EVBT ( p<0.01 ) . Late thrombotic occlusions occurred in 4 % ( 6/133 ) , exclusively in patients treated with EVBT after stent implantation . Conclusions : Endovascular brachytherapy significantly reduces restenosis , improves symptoms , and reduces re interventions after PTA of femoropopliteal arteries . Probucol reduces restenosis but has no additive effect when combined with brachytherapy
Lipid-lowering therapy is effective in reducing cardiovascular mortality and morbidity in people with PAD .
It may also improve local symptoms .
Until further evidence on the relative effectiveness of different lipid-lowering agents is available , use of a statin in people with PAD and a blood cholesterol level > /=3.5 mmol/litre is most indicated
BACKGROUND Lipid-lowering therapy is recommended for secondary prevention in people with coronary artery disease .
It may also reduce cardiovascular events and /or local disease progression in people with lower limb peripheral arterial disease ( PAD ) .
OBJECTIVES To assess the effects of lipid-lowering therapy on all-cause mortality , cardiovascular events and local disease progression in patients with PAD of the lower limb .