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 .
Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels.
BACKGROUND In patients with coronary heart disease and a broad range of cholesterol levels , cholesterol-lowering therapy reduces the risk of coronary events , but the effects on mortality from coronary heart disease and overall mortality have remained uncertain . METHODS In a double-blind , r and omized trial , we compared the effects of pravastatin ( 40 mg daily ) with those of a placebo over a mean follow-up period of 6.1 years in 9014 patients who were 31 to 75 years of age . The patients had a history of myocardial infa rct ion or hospitalization for unstable angina and initial plasma total cholesterol levels of 155 to 271 mg per deciliter . Both groups received advice on following a cholesterol-lowering diet . The primary study outcome was mortality from coronary heart disease . RESULTS Death from coronary heart disease occurred in 8.3 percent of the patients in the placebo group and 6.4 percent of those in the pravastatin group , a relative reduction in risk of 24 percent ( 95 percent confidence interval , 12 to 35 percent ; P<0.001 ) . Overall mortality was 14.1 percent in the placebo group and 11.0 percent in the pravastatin group ( relative reduction in risk , 22 percent ; 95 percent confidence interval , 13 to 31 percent ; P<0.001 ) . The incidence of all cardiovascular outcomes was consistently lower among patients assigned to receive pravastatin ; these outcomes included myocardial infa rct ion ( reduction in risk , 29 percent ; P<0.001 ) , death from coronary heart disease or nonfatal myocardial infa rct ion ( a 24 percent reduction in risk , P<0.001 ) , stroke ( a 19 percent reduction in risk , P=0.048 ) , and coronary revascularization ( a 20 percent reduction in risk , P<0.001 ) . The effects of treatment were similar for all predefined subgroups . There were no clinical ly significant adverse effects of treatment with pravastatin . CONCLUSIONS Pravastatin therapy reduced mortality from coronary heart disease and overall mortality , as compared with the rates in the placebo group , as well as the incidence of all prespecified cardiovascular events in patients with a history of myocardial infa rct ion or unstable angina who had a broad range of initial cholesterol levels
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 .