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25-11-2010 | Cardiometabolic | Article

Statins reduce CVD risk in Chinese Type 2 diabetes patients by up to 50%

Abstract

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MedWire News: Statins can reduce the risk for cardiovascular disease (CVD) by 40-50% in Chinese patients with Type 2 diabetes, research suggests.

The study also showed that high levels of low-density lipoprotein (LDL) cholesterol and low levels of high-density lipoprotein (HDL) cholesterol predicted incident CVD. In contrast, triglycerides had no significant predictive value.

The findings come from 4521 patients with Type 2 diabetes but without a history of CVD who were naïve to lipid-regulating drugs and were recruited into the Hong Kong Diabetes Registry between 1996 and 2005.

During a median follow up of 4.9 years, 371 developed CVD, report Juliana Chan (The Chinese University of Hong Kong) and colleagues in the journal Cardiovascular Diabetology.

The optimal LDL-cholesterol level for CVD risk was less than 3 mmol/l (116.0 mg/dl), and participants with levels above this had a multivariate-adjusted hazard ratio (HR) of 1.36 compared with lower levels.

HDL cholesterol exhibited a continuous and linear relationship with this risk, with each 1 mmol/l increase associated with a 1% reduction in CVD risk.

Statin use was associated with an HR of 0.66 for CVD compared with no such use, but the risk reduction with fibrates was rendered insignificant after adjusting for confounders.

A sub-analysis showed that statins were associated with a HR of 0.60 in patients with high LDL cholesterol levels of 3.0 mmol/l or more and 0.49 in those with low HDL cholesterol levels, with the latter identified as less than 1.0 mmol/l (38.7 mg/dl) in men or 1.3 mmol/l (50.3 mg/dl) in women.

Only statins were linked with a reduction in incident CVD in patients with metabolic syndrome, with an HR of 0.58. Among patients with LDL-cholesterol levels of less than 3 mmol/l, fibrates were associated with a HR of 0.34 for CVD, which was of borderline significance.

The researchers conclude: "Given the narrow risk-benefit ratio of intensive blood glucose lowering in Type 2 diabetic patients, especially those with long disease duration who often have silent ischemic disease, patients and health-care professionals must be aware of the importance of attaining recommended lipid goals to reduce CVD risks."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Anita Wilkinson

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