Article Text

Intensity of statin therapy and new hospitalizations for heart failure in patients with type 2 diabetes
  1. Ichiro Kishimoto1,
  2. Hisashi Makino1,
  3. Yoko Ohata1,
  4. Tamiko Tamanaha1,
  5. Mayu Tochiya1,
  6. Toshihisa Anzai2,
  7. Kengo Kusano2,
  8. Teruo Noguchi2,
  9. Satoshi Yasuda2,
  10. Hisao Ogawa2
  1. 1Department of Endocrinology and Metabolism, National Cerebral and Cardiovascular Center, Osaka, Japan
  2. 2Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
  1. Correspondence to Dr Ichiro Kishimoto; kishimot{at}hsp.ncvc.go.jp

Abstract

Objective To examine a relationship between statin intensity and heart failure (HF) incidence in diabetes.

Research design and methods We performed a retrospective cohort study of patients with type 2 diabetes (n=600; age, 66.3 years; men, 68%). Patients were categorized into three groups by baseline statin treatments—moderate-intensity, low-intensity, or no statin—and the independent association between the statin category and HF hospitalization during follow-up was examined.

Results Over the course of the median 6-year follow-up, 17.7% of the patients were hospitalized for HF. Cox regression analysis revealed a significant association between the baseline statin category and HF incidence (p=0.002), independently of age, sex, hypertension, B-type natriuretic peptide, glycated hemoglobin, estimated glomerular filtration rate, and low-density lipoprotein (LDL) cholesterol levels. The moderate-intensity statin group had a significantly lower risk for HF than the low-intensity statin group with an adjusted HR of 0.31 (95% CI 0.13 to 0.65, p=0.0014). Interestingly, among patients with prevalent coronary artery diseases (CAD) and with baseline LDL controlled to less than 100 mg/dL, the frequency of HF was still significantly lower in the moderate-intensity group than in the low-intensity group or the no statin group. The effect of baseline statin category on HF was independent of incident CAD events during follow-up.

Conclusions In type 2 diabetes, moderate-intensity statins, in comparison to low-intensity or no statin, were associated with lower HF incidence independently of LDL levels or of CAD events.

  • Heart Failure
  • Cardiovascular Disease Risk
  • Coronary Artery Disease
  • Cholesterol

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