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Clinical significance of recent lipid trials on reducing risk in patients with type 2 diabetes mellitus.
Am J Cardiol 2007; 99(4A):133B-140BAJ

Abstract

Type 2 diabetes mellitus is a significant risk factor for cardiovascular disease and is associated with significant cardiovascular morbidity and mortality. Current guidelines suggest lifestyle modification and at least a 30%-40% reduction of low-density lipoprotein (LDL) cholesterol with drug therapy, to a target level of <100 mg/dL. Additional secondary therapeutic targets include increasing high-density lipoprotein (HDL) cholesterol and lowering triglycerides. Although the 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) remain first-line therapy, combination therapy with statins and fibrates or niacin is often needed to achieve target levels in patients with diabetes. Statins significantly lower LDL and decrease the relative risk for nonfatal myocardial infarction (MI) or coronary artery disease death. Clinical trials have demonstrated that in high-risk patients, such as those with diabetes, monotherapy with statins reduces overall cardiovascular events by 30%-40%. Fibrates have modest effects to lower LDL, but they significantly increase HDL and reduce triglycerides, they may improve glucose tolerance, and they have been shown to reduce nonfatal MI by 25%. Although data are limited, the combination of a statin and fenofibrate significantly reduced LDL, reduced triglycerides, and increased HDL compared with a statin alone. It is hoped that ongoing trials will demonstrate the clinical outcomes benefits of combination therapy in patients with diabetes.

Authors+Show Affiliations

Methodist DeBakey Heart Center, Baylor College of Medicine, Houston, Texas 77030, USA. jones@bcm.edu

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17307065

Citation

Jones, Peter H.. "Clinical Significance of Recent Lipid Trials On Reducing Risk in Patients With Type 2 Diabetes Mellitus." The American Journal of Cardiology, vol. 99, no. 4A, 2007, 133B-140B.
Jones PH. Clinical significance of recent lipid trials on reducing risk in patients with type 2 diabetes mellitus. Am J Cardiol. 2007;99(4A):133B-140B.
Jones, P. H. (2007). Clinical significance of recent lipid trials on reducing risk in patients with type 2 diabetes mellitus. The American Journal of Cardiology, 99(4A), 133B-140B.
Jones PH. Clinical Significance of Recent Lipid Trials On Reducing Risk in Patients With Type 2 Diabetes Mellitus. Am J Cardiol. 2007 Feb 19;99(4A):133B-140B. PubMed PMID: 17307065.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical significance of recent lipid trials on reducing risk in patients with type 2 diabetes mellitus. A1 - Jones,Peter H, Y1 - 2006/12/28/ PY - 2007/2/20/pubmed PY - 2007/4/4/medline PY - 2007/2/20/entrez SP - 133B EP - 140B JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 99 IS - 4A N2 - Type 2 diabetes mellitus is a significant risk factor for cardiovascular disease and is associated with significant cardiovascular morbidity and mortality. Current guidelines suggest lifestyle modification and at least a 30%-40% reduction of low-density lipoprotein (LDL) cholesterol with drug therapy, to a target level of <100 mg/dL. Additional secondary therapeutic targets include increasing high-density lipoprotein (HDL) cholesterol and lowering triglycerides. Although the 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) remain first-line therapy, combination therapy with statins and fibrates or niacin is often needed to achieve target levels in patients with diabetes. Statins significantly lower LDL and decrease the relative risk for nonfatal myocardial infarction (MI) or coronary artery disease death. Clinical trials have demonstrated that in high-risk patients, such as those with diabetes, monotherapy with statins reduces overall cardiovascular events by 30%-40%. Fibrates have modest effects to lower LDL, but they significantly increase HDL and reduce triglycerides, they may improve glucose tolerance, and they have been shown to reduce nonfatal MI by 25%. Although data are limited, the combination of a statin and fenofibrate significantly reduced LDL, reduced triglycerides, and increased HDL compared with a statin alone. It is hoped that ongoing trials will demonstrate the clinical outcomes benefits of combination therapy in patients with diabetes. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/17307065/Clinical_significance_of_recent_lipid_trials_on_reducing_risk_in_patients_with_type_2_diabetes_mellitus_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(06)02232-6 DB - PRIME DP - Unbound Medicine ER -