Statin Use and Functional Decline in Patients With and Without Peripheral Arterial Disease

ObjectivesWe determined whether statin use (vs. non-use) is associated with less annual decline in lower-extremity functioning in patients with and without lower-extremity peripheral arterial disease (PAD) over three-year follow-up.BackgroundIt is unclear whether statin use is associated with less functional decline in patients with PAD.MethodsParticipants included 332 men and women with an ankle brachial index (ABI) <0.90 and 212 with ABI 0.90 to 1.50. Functional outcomes included 6-min walk distance and usual and rapid-pace 4-m walking velocity. A summary performance score combined performance in walking speed, standing balance, and time for five repeated chair rises into an ordinal score ranging from 0 to 12 (12 = best).ResultsAdjusting for age, race, gender, comorbidities, education, health insurance, total cholesterol/high-density lipoprotein level, body mass index, pack-years of smoking, leg symptoms, immediately previous year functioning, statin use/non-use, ABI, and change in ABI, the PAD participants using statins had less annual decline in usual-pace walking velocity (0.002 vs. −0.024 m/s/year, p = 0.013), rapid-pace walking velocity (−0.006 vs. −0.042 m/s/year, p = 0.006), 6-min walk performance (−34.5 vs. −57.9 feet/year, p = 0.088), and the summary performance score (−0.152 vs. −0.376, p = 0.067) compared with non-users. These associations were attenuated slightly by additional adjustment for high-sensitivity C-reactive protein levels. Among non-PAD participants, there were no significant associations between statin use and functional decline.ConclusionsThe PAD patients on statins have less annual decline in lower-extremity performance than PAD patients who are not taking statins.