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 .
Sulodexide in the treatment of intermittent claudication. Results of a randomized, double-blind, multicentre, placebo-controlled study.
AIMS Patients with peripheral arterial obstructive disease require treatment to prevent major cardiovascular events and to relieve intermittent claudication . The walking performance of peripheral arterial obstructive disease patients was used to evaluate the usefulness of sulodexide , a glycosaminoglycan containing fast moving heparin and dermatan sulphate . METHODS AND RESULTS A r and omized , multicentre , double-blind , placebo-controlled study was performed in 286 patients with Leriche-Fontaine stage II peripheral arterial obstructive disease . Patients received placebo ( n=143 ) or sulodexide ( n=143 ) for 27 weeks . The primary end-point was the doubling of the pain-free walking distance at the end of treatment , and this was achieved by 23.8 % of patients treated with sulodexide and 9.1 % of those on placebo ( P=0.001 ) . The pain-free walking distance increased on average ( + /-SE ) by 83.2+/-8.6 m ( + 64.7 % from baseline ) with sulodexide and 36.7+/-6.2 m ( + 29.9 % from baseline ) with placebo ( P=0.001 ) . The maximum walking distance increased by 142.3+/-15.8 m ( + 76.0 % from baseline ) and 54.5+/-8.4 m ( + 27.9 % from baseline ) ( P<0.001 ) , respectively . Results for patients with type II diabetes were similar to those for non-diabetic patients .  Plasma fibrinogen decreased with sulodexide , but increased with placebo . CONCLUSION Sulodexide improved the walking ability of peripheral arterial obstructive disease patients to a significantly greater extent than placebo , with a concurrent significant decrease in fibrinogen . The treatment was well tolerated
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 .