Effect of statins on total cholesterol concentrations and cardiovascular outcomes in patients with diabetes mellitus: a population-based cohort study

Sheng, Xia; Murphy, Michael J.; MacDonald, Thomas M.; Li, Wei

doi:10.1007/s00228-012-1234-5

Cited by 23 publications

(20 citation statements)

References 13 publications

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“…This may be because of the regular use of the lipid lowering drugs used by >80% of the CVD and hypertensive patients of this study. Previous studies have shown the reduction in cardiovascular morbidity and mortality in diabetic patients with statin therapy (Sheng et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Metabolic syndrome and risk of major coronary events among the urban diabetic patients: North Indian Diabetes and Cardiovascular Disease Study—NIDCVD-2

Bhatti

Bhadada

Vijayvergiya

et al. 2016

Journal of Diabetes and its Complications

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Section: Discussionmentioning

confidence: 99%

Metabolic syndrome and risk of major coronary events among the urban diabetic patients: North Indian Diabetes and Cardiovascular Disease Study—NIDCVD-2

Bhatti

Bhadada

Vijayvergiya

et al. 2016

Journal of Diabetes and its Complications

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“…All studies included patients on lipid-lowering therapy, while one additionally included patients with elevated LDL-C. Reported incidence of ischemic stroke ranged from 13.8 to 57. n/a n/a n/a n/a n/a n/a n/a n/a 27 , and an incidence rate of 15.5 (95% CI: 11.0-21.9) in statin-exposed secondary prevention CKD patients 28 . In Thai patients with angina pectoris or MI discharges, Chinwong et al 20 reported incidence rates for unspecified nonfatal stroke of 0, 4 and 0 per 1000 person-years in those with LDL-C <70 mg/dL, LDL-C 70-99 mg/dL and LDL-C 100 mg/dL, respectively.…”

Section: Ischemic Stroke/transient Ischemic Attack Ratesmentioning

confidence: 99%

“…Incidence of CV-related mortality was reported in four studies, ranging from 1.0 to 94.5 (median: 21.1) per 1000 personyears 22,23,27,28 . Incidence of all-cause mortality was reported in eight studies, ranging from 9.7 to 486 (median: 52.6) per 1000 person-years [19][20][21][22][26][27][28][29][30] . Three studies included ASCVD patients.…”

Section: Mortalitymentioning

confidence: 99%

“…27 . In the study among patients with chronic kidney disease (CKD), the nonfatal MI incidence rate was 26.8 per 1000 person-years (95% CI: 20.6-34.9) among the statin-exposed secondary prevention cohort 28 .…”

Section: Myocardial Infarction Ratementioning

confidence: 99%

“…Among the nine included studies reporting mortality rates, all evaluated patients on lipid-lowering therapy [20][21][22][23][26][27][28][29][30] . Incidence of CV-related mortality was reported in four studies, ranging from 1.0 to 94.5 (median: 21.1) per 1000 personyears 22,23,27,28 .…”

Section: Mortalitymentioning

confidence: 99%

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Real-world cardiovascular disease burden in patients with atherosclerotic cardiovascular disease: a comprehensive systematic literature review

Cherepanov

Bentley

Hsiao

et al. 2018

Current Medical Research and Opinion

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Objective: Based on randomized controlled trials (RCTs), non-fatal myocardial infarction (MI) rates range between 9 and 15 events per 1000 person-years, ischemic stroke between 4 and 6 per 1000 person-years, CHD death rates between 5 and 7 events per 1000 person-years, and any major vascular event between 28 and 53 per 1000 person-years in patients with atherosclerotic cardiovascular disease (ASCVD). We reviewed global literature on the topic to determine whether the real-world burden of secondary major adverse cardiovascular events (MACEs) is higher among ASCVD patients. Methods: We searched PubMed and Embase using MeSH/keywords including cardiovascular disease, secondary prevention and observational studies. Studies published in the last 5 years, in English, with 50 subjects with elevated low-density lipoprotein cholesterol (LDL-C) or on statins, and reporting secondary MACEs were included. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of each included study. Results: Of 4663 identified articles, 14 studies that reported MACE incidence rates per 1000 personyears were included in the review (NOS grades ranged from 8 to 9; 2 were prospective and 12 were retrospective studies). Reported incidence rates per 1000 person-years had a range (median) of 12.01-39.9 (26.8) for MI, 13.8-57.2 (41.5) for ischemic stroke, 1.0-94.5 (21.1) for CV-related mortality and 9.7-486 (52.6) for all-cause mortality. Rates were 25.8-211 (81.1) for composite of MACEs. Multiple event rates had a range (median) of 60-391 (183) events per 1000 person-years. Conclusions: Our review indicates that MACE rates observed in real-world studies are substantially higher than those reported in RCTs, suggesting that the secondary MACE burden and potential benefits of effective CVD management in ASCVD patients may be underestimated if real-world data are not taken into consideration. ARTICLE HISTORY

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Emerging innovative therapeutic approaches targeting PCSK9 to lower lipids

Shantha

Robinson

2015

Clin Pharma and Therapeutics

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Statins are established therapies for cardiovascular disease prevention and ezetimibe has recently been shown to modestly reduce cardiovascular events when added to background statin therapy. Yet here remains a clear unmet need for additional therapies aimed at lowering low density lipoprotein cholesterol (LDL-C) to further reduce cardiovascular risk. Multiple strategies targeting proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition have emerged as effective modalities for LDL-C lowering. PCSK9 monoclonal antibodies are the farthest along in clinical development and alirocumab and evolocumab were approved for clinical use by regulatory agencies in 2015. In addition to robust LDL-C lowering (nearly 50-65% from baseline), they improve other lipid parameters as well. Adverse events associated with these medications are minimal. Importantly, they improve clinical cardiovascular disease outcomes, although long-term study results are awaited. Cost may be an important limiting factor in their use and we propose two possible solutions which can potentially curtail cost.

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Effect of statins on total cholesterol concentrations and cardiovascular outcomes in patients with diabetes mellitus: a population-based cohort study

Abstract: Statin use was as effective in diabetic patients in the setting of usual care, as in the clinical trials, in both primary and secondary prevention. TC changes can be used as a measure of statin efficacy in the absence of low-density lipoprotein cholesterol (LDL-C) in diabetic patients.

Cited by 23 publications

References 13 publications

Metabolic syndrome and risk of major coronary events among the urban diabetic patients: North Indian Diabetes and Cardiovascular Disease Study—NIDCVD-2

Metabolic syndrome and risk of major coronary events among the urban diabetic patients: North Indian Diabetes and Cardiovascular Disease Study—NIDCVD-2

Real-world cardiovascular disease burden in patients with atherosclerotic cardiovascular disease: a comprehensive systematic literature review

Emerging innovative therapeutic approaches targeting PCSK9 to lower lipids

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