Trial reportJournal of the American College of Cardiology2011
Low-density lipoprotein lowering does not improve calf muscle perfusion, energetics, or exercise performance in peripheral arterial disease.
Trial report in Journal of the American College of Cardiology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00587678 (Comprehensive Magnetic Resonance of Peripheral Arterial Disease), which is not on this map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comprehensive Magnetic Resonance of Peripheral Arterial Disease
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Ezetimibe for the prevention of cardiovascular disease and all-cause mortality events.The Cochrane database of systematic reviews · 2018 · on this mapPooled it
- Percutaneous intervention in peripheral artery disease improves calf muscle phosphocreatine recovery kinetics: a pilot study.Vascular medicine (London, England) · 2012Trial
- Real-Time Monitoring of Atherosclerotic Plaque Using β-Galactosidase-Activated Photoacoustic Tomography.Small (Weinheim an der Bergstrasse, Germany) · 2025Article
- Role of Lipids and Lipid Management Therapy Among Patients With Peripheral Artery Disease: A Reappraisal of the Current Evidence and Future Directions.Journal of the American Heart Association · 2025Review
- Recent advances in magnetic resonance imaging for peripheral artery disease.Vascular medicine (London, England) · 2018Review
- Spectral improvement by fourier thresholding of in vivo dynamic spectroscopy data.Magnetic resonance in medicine · 2016Article
- Iron and atherosclerosis: nailing down a novel target with magnetic resonance.Journal of cardiovascular translational research · 2014Review
- Review
- Oxygenation and flow in the limbs: Novel methods to characterize peripheral artery disease.Current cardiovascular imaging reports · 2013Article
- MRI in Lower Extremity Peripheral Arterial Disease: Recent Advancements.Current cardiovascular imaging reports · 2013Article
- Arterial spin labeling MR imaging reproducibly measures peak-exercise calf muscle perfusion: a study in patients with peripheral arterial disease and healthy volunteers.JACC. Cardiovascular imaging · 2012Article
- Review
- Article
- Peripheral arterial disease of the lower extremities.Archives of medical science : AMS · 2012Article
- LDL lowering in peripheral arterial disease: are there benefits beyond reducing cardiovascular morbidity and mortality?Clinical lipidology · 2012Article
Corrections and comments
- Commented on by
Authors and funding
13 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesWe hypothesized that low-density lipoprotein (LDL) reduction regardless of mechanism would improve calf muscle perfusion, energetics, or walking performance in peripheral arterial disease (PAD) as measured by magnetic resonance imaging and magnetic resonance spectroscopy.
backgroundStatins improve cardiovascular outcome in PAD, and some studies suggest improved walking performance.
methodsSixty-eight patients with mild to moderate symptomatic PAD (age 65 ± 11 years; ankle-brachial index [ABI] 0.69 ± 0.14) were studied at baseline and annually for 2 years after beginning simvastatin 40 mg (n = 20) or simvastatin 40 mg/ezetimibe 10 mg (n = 18) if statin naïve, or ezetimibe 10 mg (n = 30) if taking a statin. Phosphocreatine recovery time was measured by (31)P magnetic resonance spectroscopy immediately after symptom-limited calf exercise on a 1.5-T scanner. Calf perfusion was measured using first-pass contrast-enhanced magnetic resonance imaging with 0.1 mM/kg gadolinium at peak exercise. Gadolinium-enhanced magnetic resonance angiography was graded. A 6-min walk and a standardized graded Skinner-Gardner exercise treadmill test with peak Vo(2) were performed. A repeated-measures model compared changes over time.
resultsLDL reduction from baseline to year 2 was greater in the simvastatin 40 mg/ezetimibe 10 mg group (116 ± 42 mg/dl to 56 ± 21 mg/dl) than in the simvastatin 40 mg group (129 ± 40 mg/dl to 90 ± 30 mg/dl, p < 0.01). LDL also decreased in the ezetimibe 10 mg group (102 ± 28 mg/dl to 79 ± 27 mg/dl, p < 0.01). Despite this, there was no difference in perfusion, metabolism, or exercise parameters between groups or over time. Resting ABI did improve over time in the ezetimibe 10 mg group and the entire study group of patients.
conclusionsDespite effective LDL reduction in PAD, neither tissue perfusion, metabolism, nor exercise parameters improved, although rest ABI did. Thus, LDL lowering does not improve calf muscle physiology or functional capacity in PAD. (Comprehensive Magnetic Resonance of Peripheral Arterial Disease; NCT00587678).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.