Statin Use And Risk Of Developing Diabetes In Cardiovascular Disease: Systematic Literature Review And Meta-Analysis

Abstract

Objectives: Statins are widely used for the primary and secondary prevention of cardiovascular diseases (CVDs). Studies have shown that statins may induce diabetes in non-diabetic CVD patients, as class effect. This systematic literature review aims to evaluate the risk of developing diabetes in CVD patients receiving statins. MethOds: Randomized controlled trials (RCTs), which used any statin as an intervention for non-diabetic CVD patients, were identified from August 2010 to June 2014 in databases such as, Embase, PubMed, and Cochrane. The timeframe of the searches was selected post the study conducted by Mills et al. in 2011. This review will also include relevant studies from the Mills et al. study until August 2010. Two researchers will independently review studies as per the Cochrane methodology for systematic reviews. The primary outcome is the incidence of diabetes. Subgroup analyses will also be performed to assess whether statin type, age, ethnicity or patient groups contribute to the intensity of the risk of developing diabetes. Results: In total, 5238 potentially relevant studies were retrieved from the databases and are being screened for inclusion in the review. The data extraction and analyses (both qualitative and quantitative) are being performed and the full results will be presented in the poster. cOnclusiOns: This systematic literature review is an update of the findings of a previous study and will hopefully throw more light on the association between statin use and the risk of diabetes in CVD patients, with special emphasis on subgroups.Objectives: The aim of this retrospective cohort study was to calculate hazard rates of CV/non-CV related death in risk patients stratified by statin dose and to generate data for health-economic analyses. MethOds: Anonymous retrospective electronic medical records were extracted from a 10% sample of the Swedish population > 18 years in primary care and merged with hospital records, prescribed drugs, and death data by National Board of Health and Welfare. Cohorts were defined as diabetic (DM), Clinically-evident CardioVascular Disease (CeCVD), Acute Coronary Syndrome (ACS), Heart Failure (HF) and Ischemic Stroke (IS) patients. CV/non-CV related death was investigated. The population was divided into high dose statin users (> 40 mg simvastatin or equivalent) and non-statin users. Royston Parmar (RP) spline analysis was used to calculate hazard rates of both outcomes in each cohort to enable a smooth hazard function with good fit to data compared to ordinary Cox regression. Initial AIC-based optimization demonstrated that modeling of the log cumulative odds as a spline function of log time and three nodes gave the best fit. Crude rates were calculated for each cohort and event, and hazard rates adjusted for gender, diabetes, LDL (where applicable) and age were calculated. Results: The total database consisted of 1.3 million patients; there were 55,778 DM, 47,581 CeCVD, 49,857 ACS, 82,835 HF and 38,949 IS patients. High dose statin users showed after initial de...