Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/10670
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dc.contributor.authorAung, Phyu Phyuen_UK
dc.contributor.authorMaxwell, Heatheren_UK
dc.contributor.authorJepson, Ruthen_UK
dc.contributor.authorPrice, Jackieen_UK
dc.contributor.authorLeng, Gillian Cen_UK
dc.date.accessioned2018-05-05T01:14:03Z-
dc.date.available2018-05-05T01:14:03Z-
dc.date.issued2009en_UK
dc.identifier.otherCD000123.pub2en_UK
dc.identifier.urihttp://hdl.handle.net/1893/10670-
dc.description.abstractBackground: Lipid-lowering therapy is recommended for secondary prevention in people with coronary artery disease. It may also reduce cardiovascular events and/or local disease progression in people with lower limb peripheral arterial disease (PAD). Objectives: To assess the effects of lipid-lowering therapy on all-cause mortality, cardiovascular events and local disease progression in patients with PAD of the lower limb. Search methods: The authors searched The Cochrane Peripheral Vascular Diseases Group's Specialised Register (last searched February 2007) and the Cochrane Central Register of Controlled Trials (CENTRAL) (last searched Issue 2, 2007) for publications describing randomised controlled trials of lipid-lowering therapy in peripheral arterial disease of the lower limb. Selection criteria: Randomised controlled trials of lipid-lowering therapy in patients with PAD of the lower limb. Data collection and analysis: Three authors independently assessed trial quality and extracted data. Main results: Eighteen trials were included, involving a total of 10,049 participants. Trials differed considerably in their inclusion criteria, outcomes measured, and type of lipid-lowering therapy used. Only one trial (PQRST) reported a detrimental effect of active treatment on blood lipid/lipoprotein levels. The pooled results from all eligible trials indicated that lipid-lowering therapy had no statistically significant effect on overall mortality (Odds Ratio (OR) 0.86; 95% Confidence Interval (CI) 0.49 to 1.50) or on total cardiovascular events (OR 0.8; 95% CI 0.59 to 1.09). However, subgroup analysis which excluded PQRST showed that lipid-lowering therapy significantly reduced the risk of total cardiovascular events (OR 0.74; CI 0.55 to 0.98). This was primarily due to a positive effect on total coronary events (OR 0.76; 95% CI 0.67 to 0.87). Greatest evidence of effectiveness came from the use of simvastatin in people with a blood cholesterol ≥ 3.5 mmol/litre (HPS). Pooling of the results from several small trials on a range of different lipid-lowering agents indicated an improvement in total walking distance (Mean Difference (MD) 152 m; 95% CI 32.11 to 271.88) and pain-free walking distance (WMD 89.76 m; 95% CI 30.05 to 149.47) but no significant impact on ankle brachial index (WMD 0.04; 95% CI -0.01 to 0.09). Authors' conclusions: Lipid-lowering therapy is effective in reducing cardiovascular mortality and morbidity in people with PAD. It may also improve local symptoms. Until further evidence on the relative effectiveness of different lipid-lowering agents is available, use of a statin in people with PAD and a blood cholesterol level ≥ 3.5 mmol/litre is most indicated.en_UK
dc.language.isoenen_UK
dc.publisherWiley-Blackwell for the Cochrane Collaborationen_UK
dc.relationAung PP, Maxwell H, Jepson R, Price J & Leng GC (2009) Lipid-lowering for peripheral arterial disease of the lower limb (Review) [Lipid-lowering for lower limb atherosclerosis]. Cochrane Database of Systematic Reviews, (1), Art. No.: CD000123.pub2. https://doi.org/10.1002/14651858.CD000123.pub2en_UK
dc.rightsThis review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2009, Issue 1, 'Lipid-lowering for peripheral arterial disease of the lower limb'. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review. This is the reference to the original version of this review: Leng GC, Price JF, Jepson RG. Lipid-lowering for lower limb atherosclerosis. Cochrane Database of Systematic Reviews 1998, Issue 4. Art. No.: CD000123. DOI: 10.1002/14651858.CD000123.en_UK
dc.titleLipid-lowering for peripheral arterial disease of the lower limben_UK
dc.title.alternativeLipid-lowering for lower limb atherosclerosisen_UK
dc.typeJournal Articleen_UK
dc.identifier.doi10.1002/14651858.CD000123.pub2en_UK
dc.identifier.pmid10796489en_UK
dc.citation.jtitleCochrane Database of Systematic Reviewsen_UK
dc.citation.issn1469-493Xen_UK
dc.citation.issue1en_UK
dc.citation.publicationstatusPublisheden_UK
dc.citation.peerreviewedRefereeden_UK
dc.type.statusVoR - Version of Recorden_UK
dc.author.emailruth.jepson@stir.ac.uken_UK
dc.description.notesOutput Type: Reviewen_UK
dc.contributor.affiliationUniversity of Edinburghen_UK
dc.contributor.affiliationUniversity of Edinburghen_UK
dc.contributor.affiliationHealth Sciences Stirlingen_UK
dc.contributor.affiliationUniversity of Edinburghen_UK
dc.contributor.affiliationLondon School of Hygiene and Tropical Medicineen_UK
dc.identifier.wtid889207en_UK
dc.contributor.orcid0000-0002-9446-445Xen_UK
dcterms.dateAccepted2009-12-31en_UK
dc.date.filedepositdate2013-01-21en_UK
rioxxterms.typeJournal Article/Reviewen_UK
rioxxterms.versionVoRen_UK
local.rioxx.authorAung, Phyu Phyu|en_UK
local.rioxx.authorMaxwell, Heather|en_UK
local.rioxx.authorJepson, Ruth|0000-0002-9446-445Xen_UK
local.rioxx.authorPrice, Jackie|en_UK
local.rioxx.authorLeng, Gillian C|en_UK
local.rioxx.projectInternal Project|University of Stirling|https://isni.org/isni/0000000122484331en_UK
local.rioxx.freetoreaddate2013-01-21en_UK
local.rioxx.licencehttp://www.rioxx.net/licenses/all-rights-reserved|2013-01-21|en_UK
local.rioxx.filenameAung et al_Cochrane_2009.pdfen_UK
local.rioxx.filecount1en_UK
Appears in Collections:Faculty of Health Sciences and Sport Systematic Reviews

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