Atorvastatin Treatment for Carotid Intima-Media Thickness in Chinese Patients With Type 2 Diabetes

Abstract

Impact of atorvastatin on carotid intima-media thickness (CIMT) in patients with type 2 diabetes is still debating.The aim of our study is to investigate atorvastatin as adjuvant treatment on CIMT in Chinese patients with type 2 diabetes by conducting a meta-analysis based on the randomized controlled trials (RCTs).A systematic search of electronic database of the Pubmed, EMBASE, Cochrane Library, VIP database, China National Knowledge Infrastructure, and Wangfang up to January 2015 was conducted. Randomized controlled trials (RCTs) comparing atorvastatin adjuvant treatment to the hypoglycemic therapies or high-dose atorvastatin versus low-dose atorvastatin therapies for patients with type 2 diabetes were selected.A total of 14 RCTs involving 1345 patients were included. Adjuvant treatment with atorvastatin was associated with a significant reduction in CIMT (weighted mean difference [WMD] = −0.17 mm; 95% confidence interval [CI] −0.22 to −0.12). Compared with the low-dose atorvastatin, high-dose atorvastatin treatment was associated with a significant reduction in CIMT (WMD = −0.17 mm; 95% CI: −0.32 to −0.02). Adjuvant treatment with atorvastatin reduced serum total cholesterol, triglyceride, low-density lipoproteins, and high sensitivity C-reactive protein levels. However, atorvastatin had no significant impact on blood glucose levels.This meta-analysis demonstrated that treatment with atorvastatin significantly reduced CIMT in Chinese patients with type 2 diabetes. Moreover, high-dose atorvastatin appeared to have additional benefits in reducing CIMT than the low-dose atorvastatin.

Causes of changes in carotid intima-media thickness: a literature review

“…Interventions to lower LDL cholesterol from the suboptimal to the optimal range were shown to have potentially significant benefits to firefighters [ 34 ]. Atorvastatin [ 47 ], rosuvastatin [ 48 ] and fuvastatin [ 49 ] treatments slowed or reduced the progression of CIMT; intensive lipid lowering and antihypertensive therapy along with a reduction in central fat [ 50 ] may be considered a mandatory treatment strategy in young patients with FH to prevent atherosclerosis and to increase arterial stiffness. In men with CHD and high levels of Lp(a), atorvastatin use [ 51 ] results in an average 0.06Â mm decrease in CIMT over 6Â months.…”

Changes in carotid intima‐media thickening in patients with type 2 diabetes mellitus: Subanalysis of the Sitagliptin Preventive Study of Intima‐Media Thickness Evaluation

“…These data suggest that treatment with dipeptidyl peptidase‐4 inhibitors seems to prevent the progression of carotid atherosclerosis regardless of disease burden. Previous studies showed that treatment with statins and angiotensin‐converting enzyme inhibitors reduces the progression of carotid atherosclerosis in patients with type 2 diabetes mellitus3, 4. In this subgroup analysis, sitagliptin still attenuated the progression of carotid IMT, even in patients who were receiving those therapies.…”

Sitagliptin on Carotid Intima-Media Thickness in Type 2 Diabetes Mellitus Patients and Anemia: A Subgroup Analysis of the PROLOGUE Study

“…As an adjunct treatment for statins, angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers, it seems to have a unique or additive antiatherosclerotic effects in T2DM patients without anemia. Previous studies have confirmed that statins and angiotensinconverting enzyme inhibitors can reduce the development of atherosclerosis in T2DM patients [54,55]. The T2DM patients without anemia risk factors should choose more appropriate drugs for prevention and treatment.…”