In Patients with Cardiovascular Disease, Do Statins Alone, or in Combination with Other Medications Improve Mortality?

Abstract

Patients with peripheral arterial disease are at increased risk of cardiovascular morbidity and mortality and dyslipidemia is a key factor in the formation of peripheral arterial disease. Statin therapy not only effectively lowers serum cholesterol, but also exhibits pleiotropic effects that reduce vascular inflammation and results in plaque stabilization, halting and potentially reversing the progression of peripheral arterial disease. Many hypothesize that satin therapy can improve survival in patients who undergo vascular surgery. While a definitive pathway remains elusive, several studies demonstrate a clear association between statin therapy and improved survival among these patients. Several data suggest that the addition of anti-platelet therapy to statin therapy may confer additional survival benefit. It is less clear, however, whether other medical therapy, such as angiotensin-converting enzyme inhibitors, calcium channel blockers or fenobibrate provides any additive survival benefit in addition to statins.