Drugs called statins and ACE inhibitors can save those patients' lives, or their limbs, if they take the medications before having a leg bypass operation, the study finds.
But the U-M researchers found that only about half of patients whose leg vessel disease has progressed far enough to require a bypass operation are actually taking the potentially beneficial drugs.
The results, published in the February issue of the Journal of Vascular Surgery, suggest that vascular surgeons should make sure their patients are receiving appropriate drugs before performing leg bypass surgery to re-route blood flow around a severely clogged leg artery.
"What we found surprised us," says lead author and U-M vascular surgeon Peter Henke, M.D. "Patients who were taking statins before their leg bypass operation had better patency, or openness, of their bypass graft, and a lower risk of leg amputation after surgery. Those taking ACE inhibitors had a lower risk of dying after the operation. And the effect of the medications far outweighed the effects of the patients' PAD severity, other medical problems, or the type of graft used."
An estimated 12 million Americans have peripheral arterial disease, or PAD, in which clogged or stiffened leg arteries cause pain during walking or rest. Left untreated, PAD can cause non-healing wounds and gangrene, and can led to amputation unless the blocked area is opened or bypassed. It's also associated with a high risk of heart attack and stroke.
The new U-M study looked at the usage rates and effects of statins and ACE inhibitors in 293 patients with advanced PAD who had open-leg bypass operations at the U-M Health System between 1997 and 2002. Average follow-up was 17 month
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
27-Jan-2004