+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Moderate-intensity statin therapy seems ineffective in primary cardiovascular prevention in patients with type 2 diabetes complicated by nephropathy. A multicenter prospective 8 years follow up study



Moderate-intensity statin therapy seems ineffective in primary cardiovascular prevention in patients with type 2 diabetes complicated by nephropathy. A multicenter prospective 8 years follow up study



Cardiovascular Diabetology 15(1): 147



Although numerous studies and metanalysis have shown the beneficial effect of statin therapy in CVD secondary prevention, there is still controversy such the use of statins for primary CVD prevention in patients with DM. The purpose of this study was to evaluate the occurrence of total major adverse cardio-vascular events (MACE) in a cohort of patients with type 2 diabetes complicated by nephropathy treated with statins, in order to verify real life effect of statin on CVD primary prevention. We conducted an observational prospective multicenter study on 564 patients with type 2 diabetic nephropathy free of cardiovascular disease attending 21 national outpatient diabetes clinics and followed them up for 8 years. 169 of them were treated with statins (group A) while 395 were not on statins (group B). Notably, none of the patients was treated with a high-intensity statin therapy according to last ADA position statement. Total MACE occurred in 32 patients from group A and in 68 patients from group B. Fatal MACE occurred in 13 patients from group A and in 30 from group B; nonfatal MACE occurred in 19 patients from group A and in 38 patients from group B. The analysis of the Kaplan-Meier survival curves showed a not statistically significant difference in the incidence of total (p 0.758), fatal (p 0.474) and nonfatal (p 0.812) MACE between the two groups. HbA1c only showed a significant difference in the incidence of MACE between the two groups (HR 1.201, CI 1.041-1.387, p 0.012). These findings suggest that, in a real clinical setting, moderate-intensity statin treatment is ineffective in cardiovascular primary prevention for patients with diabetic nephropathy. Trial registration ClinicalTrials.gov Identifier NCT00535925. Date of registration: September 24, 2007, retrospectively registered.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 058330969

Download citation: RISBibTeXText

PMID: 27733159

DOI: 10.1186/s12933-016-0463-9


Related references

A prospective study of cardiovascular disease in patients with type 2 diabetes 6.3 years of follow-up. Journal of Diabetes & its Complications 17(5): 235-242, September-October, 2003

Statins Ineffective for Primary Prevention of Cardiovascular Disease in Patients 75 Years or Older Without Diabetes Mellitus. American Family Physician 99(7): 461, 2019

Lack of effect of aspirin in primary CV prevention in type 2 diabetic patients with nephropathy: results from 8 years follow-up of NID-2 study. Acta Diabetologica 52(2): 239-247, 2016

Statin and aspirin therapy for the prevention of cardiovascular events in patients with type 2 diabetes mellitus. Clinical Cardiology 35(12): 722-729, 2013

Fenofibrate and statin therapy, compared with placebo and statin, slows the development of retinopathy in type 2 diabetes patients of 10 years duration: the ACCORD study. Evidence-Based Medicine 16(2): 45-46, 2011

Effect of moderate-intensity statin therapy on plaque inflammation in patients with acute coronary syndrome: A prospective interventional study evaluated by 18F-FDG PET/CT of the carotid artery. Cardiology Journal 2018, 2018

Baseline and 1-year interim follow-up assessment of Japanese patients initiating insulin therapy who were enrolled in the cardiovascular risk evaluation in people with type 2 diabetes on insulin therapy study: an international, multicenter, observational study. Cardiovascular Diabetology 12: 131, 2014

Primary prevention of cardiovascular complications in type II diabetes patients using aspirin: a complicated tale. American Journal of Therapeutics 20(3): 275-278, 2013

Development and Validation of a Model to Predict Absolute Vascular Risk Reduction by Moderate-Intensity Statin Therapy in Individual Patients With Type 2 Diabetes Mellitus: The Anglo Scandinavian Cardiac Outcomes Trial, Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial, and Collaborative Atorvastatin Diabetes Study. Circulation. Cardiovascular Quality and Outcomes 9(3): 213-221, 2017

Teaching and motivating patients to control their risk factors retards progression of cardiovascular as well as microvascular sequelae of Type 2 diabetes mellitus- a randomized prospective 8 years follow-up study. Diabetic Medicine 22(4): 410-414, 2005

Statin therapy in the primary and secondary prevention of coronary artery disease in patients with type 2 diabetes. A scientific review. Revista Portuguesa de Cardiologia 23(11): 1461-1482, 2005

Statin utilization patterns for the primary prevention of cardiovascular events: a retrospective study in patients with diabetes mellitus in Hong Kong. American Journal of Cardiovascular Drugs 8(3): 199-205, 2008

Statin Therapy: Diabetes Mellitus Risk and Cardiovascular Benefit in Primary Prevention. Israel Medical Association Journal 20(8): 480-485, 2018

Cardiovascular biomarkers, cardiac dysfunction, and outcomes in patients with type 2 diabetes: a prospective, multicenter study. Diabetes Care 36(9): E137-E138, 2014

Impact of prior chronic statin therapy and high-intensity statin therapy at discharge on circulating endothelial progenitor cell levels in patients with acute myocardial infarction: a prospective observational study. European Journal of Clinical Pharmacology 70(10): 1181-1193, 2015