Statin therapy after infrainguinal bypass surgery for XXXX is associated with improved 5-year survival.

@entity1 @entity101 @entity6 @entity301 @entity63 @entity583
OBJECTIVE: Although statin therapy has been linked to fewer short-term complications after infrainguinal bypass, its effect on long-term survival remains unclear. We therefore examined associations between statin use and long-term mortality, graft occlusion, and amputation after infrainguinal bypass. METHODS: We used the Vascular Study Group of New England registry to study 2067 @entity1 (71% male; mean age, 67     11  years; 67% with @entity63 [ @entity63 ]) who underwent infrainguinal bypass from 2003 to 2011. Of these, 1537 (74%) were on statins perioperatively and at 1-year follow-up, and 530 received no statin. We examined crude, adjusted, and propensity-matched rates of 5-year surviva1, 1-year amputation, graft occlusion, and perioperative @entity583 . RESULTS: @entity1 taking statins at the time of surgery and at the 1-year follow-up were more likely to have @entity301 (38% vs 22%; P  < .001), @entity6 (51% vs 36%; P  < .001), @entity101 (89% vs 77%; P  < .001), and prior revascularization procedures (50% vs 38%; P  < .001). Despite higher comorbidity burdens, long-term survival was better for @entity1 taking statins in crude (risk ratio [RR], 0.7; P  < .001), adjusted (hazard ratio, 0.7; P  = .001), and propensity-matched analyses (hazard ratio, 0.7; P  = .03). In subgroup analysis, a survival advantage was evident in @entity1 on statins with @entity63 (5-year survival rate, 63% vs 54%; log-rank, P  = .01) but not claudication (5-year survival rate, 84% vs 80%; log-rank, P  = .59). Statin therapy was not associated with 1-year rates of major amputation (12% vs 11%; P  = .84) or graft occlusion (20% vs 18%; P  = .58) in @entity63 @entity1 . Perioperative @entity583 occurred more frequently in @entity1 on a statin in crude analysis (RR, 2.2; P  = .01) but not in the matched cohort (RR, 1.9; P  = .17). CONCLUSIONS: Statin therapy is associated with a 5-year survival benefit after infrainguinal bypass in @entity1 with @entity63 . However, 1-year limb-related outcomes were not influenced by statin use in our large observational cohort of @entity1 undergoing revascularization in New England.
