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 .
Cost-effectiveness of simvastatin in people at different levels of vascular disease risk: economic analysis of a randomised trial in 20,536 individuals.
BACKGROUND Statin therapy reduces the rates of heart attack , stroke , and revascularisation among a wide range of individuals . Reliable assessment of its cost-effectiveness in different circumstances is needed . METHODS 20,536 adults ( aged 40 - 80 years ) with vascular disease or diabetes were r and omly allocated 40 mg simvastatin daily ( 10,269 ) or placebo ( 10,267 ) for an average of 5 years . Comparisons were made of hospitalisation and statin costs ( 2001 UK prices ) during the scheduled treatment period between all simvastatin-allocated versus all placebo-allocated participants . Cost-effectiveness was estimated among different categories of participant . FINDINGS Allocation to simvastatin was associated with a highly significant 22 % ( 95 % CI 16 - 27 ; p<0.0001 ) proportional reduction in hospitalisation costs for all vascular events , with similar proportional reductions in every subcategory of participant studied . During an average of 5 years , estimated absolute reductions in vascular event costs per person allocated 40 mg simvastatin daily ranged from UK 847 pounds sterling ( SE 137 ) in the highest risk quintile studied to 264 pounds sterling ( 48 ) in the lowest . Mean excess cost of statin therapy among participants allocated simvastatin was 1497 pounds sterling ( 8) , with similar absolute increases in every subcategory . Costs of preventing a major vascular event with 40 mg simvastatin daily ranged from 4500 pounds sterling ( 95 % CI 2300 - 7400 ) among participants with a 42 % 5-year major vascular event rate to 31,100 pounds sterling ( 22,900 - 42,500 ) among those with a 12 % rate ( corresponding to 5-year major coronary event rates of 22 % and 4 % , respectively ) . INTERPRETATION Statin therapy is cost effective for a wider range of individuals with vascular disease or diabetes than previously recognised ( particularly with lower-priced generics ) . It would be appropriate to consider reducing the estimated level of vascular event risk at which statin therapy is recommended
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 .