Abstract No. 43 Do Statins Affect Femoropopliteal Stent Patency in Peripheral Arterial Disease?

Statins are widely utilized for coronary artery disease but their use in peripheral arterial disease is less prevalent despite consensus guidelines. We evaluated femoropopliteal stent patency according to statin intensity at the time of stent placement, and compared this effect to other covariates potentially influencing stent patency. A retrospective review identified 278 discrete femoropopliteal stent constructs in 216 patients over a 10-year period; Rutherford categories were 3 (16.3%), 4 (21.4%), 5 (50.0%) and 6 (12.3%). Stent construct locations were common femoral (1.8%), superficial femoral (77.9%), superficial femoral/popliteal (13.4%) and popliteal (7.6%) arteries; 63.8% of stents were paclitaxel-eluting. Primary unassisted patency of each stent construct was determined with duplex ultrasound, angiography, or computed tomographic angiography, alone or in combination; greater than 50% restenosis or stent occlusion was considered loss of patency. Statin intensity at the time of stent placement was categorized by American Heart Association (AHA) guidelines; additional covariates were analyzed with Cox proportional hazards modeling to assess for potential effects on stent patency. Patients on no statin at the time of stent placement were nearly three times as likely to undergo loss of primary unassisted patency as patients on moderate or high intensity statin therapy (hazard ratio 2.6, 95% CI 1.5-4.6, P=0.0007); moderate/high statin therapy conferred 19 additional months of median stent patency compared with the no statin group. In multivariate Cox modeling, antiplatelet therapy, anticoagulant therapy, drug-eluting stents (vs. bare-metal or covered stents) and Rutherford class were not predictive of stent patency (P = 0.22, 0.91, 0.69 and 0.41, respectively) whereas moderate/high intensity statin therapy patients had a hazard ratio of 0.54 for loss of primary unassisted patency compared with patients not on statins (P=0.006). Statin intensity at the time of index femoropopliteal stent placement was the most predictive examined variable influencing primary unassisted patency.