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Statins, risk of diabetes, and implications on outcomes in the general population.
J Am Coll Cardiol 2012; 60(14):1231-8JACC

Abstract

OBJECTIVES

This study aimed to evaluate the association of statin exposure and incident diabetes, and subsequent outcomes in the general population.

BACKGROUND

Cardiovascular events as consequences of atherosclerosis and diabetes are reduced by statins. However, statins are associated with excessive risk of diabetes occurrence according to clinical trial analyses. From daily-practice perspectives, it remains unclear whether statin use increases risk; prognoses of diabetes after exposure require further clarification.

METHODS

From Taiwan National Health Insurance beneficiaries age ≥45 years (men) and ≥55 years (women) before 2004, subjects continuously treated with statins ≥30 days during 2000 to 2003 and nonusers before 2004 were identified. Among nondiabetic individuals at the cohort entry, controls were matched to statin users on a 4:1 ratio by age, sex, atherosclerotic comorbidities, and year of their entry. Outcomes as diabetes, major adverse cardiovascular events (MACE, the composite of myocardial infarction and ischemic stroke), and in-hospital deaths were assessed.

RESULTS

Over a median of 7.2 years, annual rates of diabetes were significantly higher in statin users (2.4% vs. 2.1%, p < 0.001), whereas MACE (hazard ratio [HR]: 0.82; 95% confidence interval [CI]: 0.68 to 0.98 for myocardial infarction; HR: 0.94; 95% CI: 0.86 to 1.03 for ischemic stroke; HR: 0.91; 95% CI: 0.84 to 0.99 for MACE]) and in-hospital mortality (HR: 0.61; 95% CI: 0.55 to 0.67]) were less. The risk-benefit analyses suggested that statin treatment was favorable in high-risk (HR: 0.89; 95% CI: 0.83 to 0.95) and secondary prevention (HR: 0.89; 95% CI: 0.83 to 0.96) populations. Among diabetic patients, prior statin use was associated with fewer MACE (HR: 0.75; 95% CI: 0.59 to 0.97). In-hospital deaths were similar in statin-related diabetes among high-risk (HR: 1.11; 95% CI: 0.83 to 1.49) and secondary prevention (HR: 1.08; 95% CI: 0.79 to 1.47) subjects compared with nondiabetic controls.

CONCLUSIONS

Risk of diabetes was increased after statins, but outcomes were favorable.

Authors+Show Affiliations

Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22884288

Citation

Wang, Kang-Ling, et al. "Statins, Risk of Diabetes, and Implications On Outcomes in the General Population." Journal of the American College of Cardiology, vol. 60, no. 14, 2012, pp. 1231-8.
Wang KL, Liu CJ, Chao TF, et al. Statins, risk of diabetes, and implications on outcomes in the general population. J Am Coll Cardiol. 2012;60(14):1231-8.
Wang, K. L., Liu, C. J., Chao, T. F., Huang, C. M., Wu, C. H., Chen, S. J., ... Chiang, C. E. (2012). Statins, risk of diabetes, and implications on outcomes in the general population. Journal of the American College of Cardiology, 60(14), pp. 1231-8. doi:10.1016/j.jacc.2012.05.019.
Wang KL, et al. Statins, Risk of Diabetes, and Implications On Outcomes in the General Population. J Am Coll Cardiol. 2012 Oct 2;60(14):1231-8. PubMed PMID: 22884288.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Statins, risk of diabetes, and implications on outcomes in the general population. AU - Wang,Kang-Ling, AU - Liu,Chia-Jen, AU - Chao,Tze-Fan, AU - Huang,Chi-Ming, AU - Wu,Cheng-Hsueh, AU - Chen,Su-Jung, AU - Chen,Tzeng-Ji, AU - Lin,Shing-Jong, AU - Chiang,Chern-En, Y1 - 2012/08/08/ PY - 2012/04/30/received PY - 2012/05/10/accepted PY - 2012/8/14/entrez PY - 2012/8/14/pubmed PY - 2012/12/19/medline SP - 1231 EP - 8 JF - Journal of the American College of Cardiology JO - J. Am. Coll. Cardiol. VL - 60 IS - 14 N2 - OBJECTIVES: This study aimed to evaluate the association of statin exposure and incident diabetes, and subsequent outcomes in the general population. BACKGROUND: Cardiovascular events as consequences of atherosclerosis and diabetes are reduced by statins. However, statins are associated with excessive risk of diabetes occurrence according to clinical trial analyses. From daily-practice perspectives, it remains unclear whether statin use increases risk; prognoses of diabetes after exposure require further clarification. METHODS: From Taiwan National Health Insurance beneficiaries age ≥45 years (men) and ≥55 years (women) before 2004, subjects continuously treated with statins ≥30 days during 2000 to 2003 and nonusers before 2004 were identified. Among nondiabetic individuals at the cohort entry, controls were matched to statin users on a 4:1 ratio by age, sex, atherosclerotic comorbidities, and year of their entry. Outcomes as diabetes, major adverse cardiovascular events (MACE, the composite of myocardial infarction and ischemic stroke), and in-hospital deaths were assessed. RESULTS: Over a median of 7.2 years, annual rates of diabetes were significantly higher in statin users (2.4% vs. 2.1%, p < 0.001), whereas MACE (hazard ratio [HR]: 0.82; 95% confidence interval [CI]: 0.68 to 0.98 for myocardial infarction; HR: 0.94; 95% CI: 0.86 to 1.03 for ischemic stroke; HR: 0.91; 95% CI: 0.84 to 0.99 for MACE]) and in-hospital mortality (HR: 0.61; 95% CI: 0.55 to 0.67]) were less. The risk-benefit analyses suggested that statin treatment was favorable in high-risk (HR: 0.89; 95% CI: 0.83 to 0.95) and secondary prevention (HR: 0.89; 95% CI: 0.83 to 0.96) populations. Among diabetic patients, prior statin use was associated with fewer MACE (HR: 0.75; 95% CI: 0.59 to 0.97). In-hospital deaths were similar in statin-related diabetes among high-risk (HR: 1.11; 95% CI: 0.83 to 1.49) and secondary prevention (HR: 1.08; 95% CI: 0.79 to 1.47) subjects compared with nondiabetic controls. CONCLUSIONS: Risk of diabetes was increased after statins, but outcomes were favorable. SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/22884288/Statins_risk_of_diabetes_and_implications_on_outcomes_in_the_general_population_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(12)02069-4 DB - PRIME DP - Unbound Medicine ER -