Effects of statin use on primary patency, mortality, and limb loss in patients undergoing lower-limb arterial angioplasty: a systematic review and meta-analysis

Abstract Purpose This study aimed to determine whether the administration of statins before, during or after lower-limb arterial angioplasty was associated with improved primary patency, mortality, and limb loss through a meta-analysis. Methods All studies on statin administration in patients undergoing lower-limb arterial angioplasty that reported the outcomes of interest (primary patency, mortality and limb loss) were included in a meta-analysis. Results Nine studies were included in this meta-analysis. Statin use in patients undergoing lower-limb arterial angioplasty was associated with improved primary patency at 12 (12.57, 95% confidence interval [CI]: 6.86–18.28, p < 0.0001) and 24 months (7.19, 95% CI: 1.02–13.37, p = 0.02), decreased mortality in 39% at 12 months (relative risk (RR): 0.61, 95% CI: 0.55–0.74, p < 0.00001) and improved amputation-free survival (AFS) in 35% (Hazard ratio: 0.65, 95% CI: 0.46–0.793, p = 0.0198). However, statin use was not associated with decreased limb loss among patients in the included studies (RR: 0.76, 95% CI: 0.56–1.04, p = 0.08). Conclusion Statin therapy was associated with significantly improved patency, overall survival, and AFS but not with limb loss after lower-limb arterial angioplasty.