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Risk of macrovascular complications in statin-treated patients developing diabetes

  • Yin-Huei Chen
    Affiliations
    Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
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  • Yu-Cih Yang
    Affiliations
    Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

    College of Medicine, China Medical University, Taichung, Taiwan
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  • Weishan Chen
    Affiliations
    Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

    College of Medicine, China Medical University, Taichung, Taiwan
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  • Yen-Nien Lin
    Affiliations
    Division of Cardiovascular Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan

    Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan

    Cardiovascular Research Laboratory, China Medical University Hospital, Taichung, Taiwan
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  • Yi-Chih Hung
    Correspondence
    Corresponding author at: Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, 2 Yuh-Der Road, Taichung 40447, Taiwan.
    Affiliations
    Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan

    Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
    Search for articles by this author
Published:September 24, 2019DOI:https://doi.org/10.1016/j.diabres.2019.107870

      Abstract

      Aims

      To assess the risk of macrovascular complications in patients developing diabetes from statin treatment.

      Methods

      In this population-based cohort study, 40,409 participants who began to receive statin therapy between 2000 and 2012 were enrolled in to the study group, and another 1:1 matched adults without statin treatment during the same period served as the control group. Both groups were followed up to identify individuals who later developed diabetes. After a follow-up identification of diabetes, diabetes and non-diabetes cohorts were subjected to an analysis for the risk of macrovascular events between diagnosis of diabetes and December 31, 2013.

      Results

      Compared with individuals without statin therapy, statin-treated patients had a higher risk of developing diabetes (adjusted hazard ratio: 2.46; 95% confidence interval: 2.37–2.57). Compared with statin-treated patients without diabetes, statin-treated participants developing diabetes had a higher overall incidence of macrovascular complications (adjusted hazard ratio: 1.74; 95% confidence interval: 1.62–1.88). Moreover, compared with that of other diabetogenic statins, patients taking pravastatin had a lower risk of developing diabetes (adjusted hazard ratio: 0.63; 95% confidence interval: 0.55–0.73) and macrovascular events (adjusted hazard ratio: 0.64; 95% confidence interval: 0.42–0.98).

      Conclusions

      According to these findings, prescribing statins that have a neutral effect on glucose homeostasis may be advisable for Asian populations.

      Keywords

      Abbreviations:

      CV (cardiovascular), NHI (Taiwan national health insurance), NHIRD (the Taiwan national health insurance research database), LHID (the longitudinal health insurance database), ACS (acute coronary syndrome), MI (myocardial infarction), PDC (proportion of follow-up days on statin use), HTN (hypertension), CHF (congestive heart failure), CKD (chronic renal disease), WOSCOPS (the West of Scotland coronary prevention study), JUPITER (justification for the use of statins in prevention: an intervention trial evaluating rosuvastatin)
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