Are statins beneficial for CVD prevention in diabetics across all age groups?
Korea: According to a recent study in the journal Diabetes Research and Clinical Practice, statin use is protective against cardiovascular disease (CVD) and all-cause mortality in patients with type 2 diabetes (T2D). The protective effect, however, was reduced after the age of 75 years and disappeared in young patients <40 years.
People with type 2 diabetes are at increased risk of cardiovascular morbidity and mortality compared to those without diabetes. Statin is used for the prevention of coronary heart disease (CHD) in patients without a history of CVD (primary prevention) and those at very high risk of developing CVD including patients with diabetes, genetic familial hyperlipidemia.
You-Cheol Hwang, Kyung Hee University School of Medicine, Seoul, Republic of Korea, and colleagues in a propensity score-matched cohort analysis addressed the question of whether statin use is associated with a reduction in CVD and mortality in patients with T2D without pre-existing CVD.
For achieving their objective the researchers created a propensity score-matched cohort analysis using retrospective data. Statin users received at least a 90-day prescription and never used statin before initiation of the study. Statin non-users never received statin throughout the study.
The primary outcome was a composite of myocardial infarction (MI), stroke, and all-cause death, and the secondary outcome was an individual event.
The propensity score-matched cohort included 168,045 statin users and 168,045 non-users (mean age 57 years; median follow-up 5.0 years).
The analysis yielded the following findings:
- Compared to statin non-users, the hazard ratio (HR) was 0.72 for composite outcomes, 0.80 for MI, 0.74 for stroke, and 0.68 for all-cause death in statin users.
- The risk reduction was most prominent in subjects aged 40–74 years, attenuated but significant in those aged ≥75 years, and not significant in those aged <40 years.
Based on the findings, the researchers concluded, statin showed a protective effect against CVD and all-cause death in type 2 diabetes; this effect was reduced beyond the age of 75 years and disappeared in young patients aged <40 years.
The study titled, "Statin use for primary prevention in patients with type 2 diabetes: Can it benefit all ages? – A nationwide propensity-matched cohort study," is published in the journal Diabetes Research and Clinical Practice.