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Statin therapy benefits diabetes patients with CHD, but normal cholesterol

By Jeremy Cockerill | February 24, 2010

Source: MedWire News

Study results show that diabetic patients with coronary heart disease (CHD), but normal cholesterol levels, benefit more from standard-dose statin therapy than nondiabetics with CHD.

“Diabetic patients have as high a risk of first myocardial infarction (MI) as nondiabetic patients with a previous MI,” say Sunao Kojima (Kumamoto University, Japan) and colleagues.

“Therefore, medical treatment of diabetic patients is very important to prevent the development and progression of cardiovascular complications,” they add.

To test the benefits of statins for cardiovascular disease (CVD) prevention in normocholesterolemic (total cholesterol of 180–240 mg/dl; 4.65–6.21 mmol/l) individuals with CHD with (n=301) or without (n=715) Type 2 diabetes, the investigators carried out a randomized open trial from 2002 to 2004.

Of the patients with Type 2 diabetes, 155 were prescribed statins and 146 were not. In a similar fashion, 348 of the nondiabetics were given statins and 367 were not.

Kojima et al report that low-density lipoprotein (LDL) cholesterol decreased by a similar amount in both diabetics and nondiabetics.

However, the number needed to treat to prevent a major CVD event (cardiovascular death, nonfatal acute MI, unstable angina, heart failure, and stroke) and the relative risk reduction for such an event was 8 and 67%, respectively, in the group with Type 2 diabetes versus 30 and 24% in the group without diabetes, a statistically significant difference.

“The data suggest that diabetes mellitus patients may enjoy the pleiotropic effects of statins, independent of the LDL cholesterol lowering effects of these agents,” conclude the authors.

The results of this study are published in the Circulation Journal.