Abstract
Aims
To investigate the effect of combined treatment with angiotensin-converting enzyme
inhibitors (ACE) and statins on mortality in diabetic patients with critical limb
ischemia (CLI).
Methods
Prospective observational study of 553 consecutive diabetic patients admitted because
of CLI followed for a mean of 2.2 years. All patients underwent peripheral revascularization
and antithrombotic therapy was prescribed or continued and therapy with statin and
ACE was recorded. Mortality from any cause was assessed and Kaplan–Meier analyses
were performed to compare the relationship between survival and recorded variables.
Results
One hundred thirty-nine patients did not have therapy with statin or an ACE, 78 had
therapy with statin without ACE, 164 had therapy with ACE without statin and 172 patients
had therapy with both statin and ACE. One hundred thirty-six patients died, 45/139
with neither statin nor ACE, 40/164 with ACE only, 26/78 with statin only, and 25/172
with both statin and ACE. Multivariate analysis confirmed the independent role of
age, history of stroke, renal insufficiency and dialysis. Combined treatment with
ACE and statin appeared to have a protective role.
Conclusions
In patients with diabetes and CLI mortality after two years is high. Life expectancy
was better in patients receiving combined therapy with ACE and statin but not with
therapy with only a statin or an ACE.
Keywords
Abbreviations:
CLI (critical limb ischemia), PAD (peripheral arterial disease), TASC (TransAtlantic intersociety Consensus), ACE (angiotensin-converting enzyme inhibitors), HbA1c (glycated hemoglobin), LDL (low-density lipoprotein cholesterol), HDL (high-density lipoprotein cholesterol), ANOVA (analysis of variance), OR (odds ratio), CI (confidence interval)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 03, 2014
Accepted:
December 30,
2013
Received in revised form:
July 23,
2013
Received:
May 28,
2013
Identification
Copyright
© 2014 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
