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Statins Could Slow Progression of Arterial Stiffness in High-Risk Patients

A retrospective analysis comparing statin users and nonusers details the significant declines in arterial stiffness progression among patients of high atherosclerotic risk based on statin use and adherence in a cohort of more than 5000 patients.

Adherence to statin therapy could reduce progression of arterial stiffness among adult patients with high atherosclerotic risk, according to a new analysis.

A retrospective cohort study comparing outcomes of statin users and nonusers, results of the study suggest continuous statin users and statin users with high adherence experienced a statistically significant slower progression of brachial-ankle pulse wave velocity (baPWV) compared to nonusers, which was not observed for those who discontinued use or had low levels of adherence to statin therapy.

“To our knowledge, this is the largest and longest study assessing the association between statin use and progression of arterial stiffness in adults with high atherosclerotic risk. The present study found that statin use was significantly associated with lower baseline baPWV and slower progressions of baPWV over a mean follow-up of 4.8 years,” wrote investigators. “Moreover, continuous and high-adherence use were associated with greater treatment benefit than discontinuation and low-adherence use.”

Few medical advances, across all specialties, have etched themselves such a notable foothold in the care of patients as statin therapy. A cornerstone in the management of dyslipidemia, statins are a first-line agent for prevention of cardiovascular disease. Citing discord between the results of recent studies examining the effects of statin therapy on arterial stiffness in patients with atherosclerotic cardiovascular disease, a team led by Shouling Wu, MD, of the Department of Cardiology at Kailuan General Hospital, launched the current study with the intent of evaluating the associations of statin use with arterial stiffness and its progression in adults with high atherosclerotic risk.

Designed as a retrospective cohort analysis, investigators used electronic medical records from the Kailuan General Hospital for patients treated from 2010-2020. Beginning in 2010, patients with at least 1 risk factor for peripheral arterial disease were invited to undergo vascular health assessments, which included baPWV measurements. Overall, 5105 adults with assessments of baPWV were identified for inclusion. This cohort had a mean age of 60.8 (SD, 9.7) years and 75.3% were men. From this groups, investigators used propensity match scoring to identify 1310 statin users and nonusers for comparison. In this comparison, statin users had a significantly lower baPWV at baseline than nonusers (difference -33.6 cm/s [95% CI, -62.1 to -5.1]).

For analyses assessing progression of baPWV, investigators identified a cohort of 1502 adults with repeat assessment of baPWV for inclusion. From this cohort, investigators matched 410 statin users with 410 nonusers for analysis. Among this cohort, over a mean follow-up of 4.8 (SD, 2.7) years, statin users had significantly slower progression of baPWV (difference, -23.3 cm/s per year [95% CI, -40.6 to -6.0]) compared to nonusers. Further analysis of patient subgroups within these cohorts demonstrated a significantly slower progression of baPWV was observed in continuous statin users (difference, -24.2 cm/s per year [95% CI, -42.2 to -6.3]) and high adherent users (difference, -39.7 cm/s per year [95% CI, -66.9 to -12.4]) when compared to nonusers. However, this trend was not observed when comparing discontinued users (difference, -17.3 cm/s per year [95% CI, -52.4 to 17.8]) and low adherent users (difference, -17.9 cm/s per year [95% CI, -36.5 to 0.7]) to nonusers.

“This retrospective cohort study found that statin use is associated with slowing the progression of baPWV among adults with high atherosclerotic risk, especially among patients who continuously take statins and have high adherence. These findings suggest that statin use provides a substantial potential in preventing the development and worsening of subclinical cardiovascular lesions at an early stage,” investigators wrote.

This study, “Association Between Statin Use and Progression of Arterial Stiffness Among Adults With High Atherosclerotic Risk,” was published in JAMA Network Open.