Concluding Comments

Trial-based evidence shows that lipid-lowering treatment is beneficial in patients with PAD. However, these patients are often under-treated despite their high risk for vascular events [19, 23]. It is also not widely appreciated that lipid lowering can improve PAD-related symptoms. The time has come for those looking after PAD patients to use aggressive preventive treatment.

Although statins can improve both clinical outcomes and symptoms in PAD, it is possible that further benefit can be obtained if LDL-C levels are lowered beyond the "older" targets for high-risk patients [from 96-100 mg/ dl (2.5-2.6 mmol/l) to 70-77 mg/dl (1.8-2.0 mmol/l)]. However, we do not know if these "new" LDL-C targets provide further symptomatic improvement or a more effective prevention of events in PAD. These issues need to be resolved by appropriately designed trials.

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