Efficacy of lipid lowering drug treatment for diabetic and non-diabetic patients: metaanalysis of randomised controlled trials
Open accessAbstract
OBJECTIVE: To evaluate the clinical benefit of lipid lowering drug treatment in patients with and without diabetes mellitus, for primary and secondary prevention. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Cochrane, Medline, Embase, and reference lists up to April 2004. STUDY SELECTION: Randomised, placebo controlled, double blind trials with a follow-up of at least three years that evaluated lipid lowering drug treatment in patients with and without diabetes mellitus. DATA EXTRACTION: Two independent reviewers extracted data. The primary outcome was major coronary events defined as coronary heart disease death, non-fatal myocardial infarction, or myocardial revascularisation procedures. RESULTS: Twelve studies were included. Lipid lowering drug treatment was found to be at least as effective in diabetic patients as in non-diabetic patients. In primary prevention, the risk reduction for major coronary events was 21% (95% confidence interval 11% to 30%; P < 0.0001) in diabetic patients and 23% (12% to 33%; P = 0.0003) in non-diabetic patients. In secondary prevention, the corresponding risk reductions were 21% (10% to 31%; P = 0.0005) and 23% (19% to 26%; P < or = 0.00001). However, the absolute risk difference was three times higher in secondary prevention. When results were adjusted for baseline risk, diabetic patients benefited more in both primary and secondary prevention. Blood lipids were reduced to a similar degree in both groups. CONCLUSIONS: The evidence that lipid lowering drug treatment (especially statins) significantly reduce cardiovascular risk in diabetic and non-diabetic patients is strong and suggests that diabetic patients benefit more, in both primary and secondary prevention. Future research should define the threshold for treatment of these patients and the desired target lipid concentrations, especially for primary prevention.
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Trial evidence confirms that statin therapy adds benefit in primary and secondary prevention of coronary artery disease.
“Although healthy lifestyle habits remain a cornerstone of T2DM management, trial data have confirmed the additional benefits of statin therapy in the primary and secondary prevention of CAD.13,102–112”
From Clinical management of stable coronary artery disease in patients with type 2 diabetes mellitus: a scientific statement from the American Heart Association (2020) · cites this paper as [107]
A large body of evidence shows that statin strategies produce similar LDL cholesterol lowering and relative cardiovascular risk reduction in people with and without type 2 diabetes.
“A large body of evidence indicates that statin-based strategies convey similar LDL-C lowering and relative cardiovascular risk reduction in patients with and those without T2DM.102–112”
From Clinical management of stable coronary artery disease in patients with type 2 diabetes mellitus: a scientific statement from the American Heart Association (2020) · cites this paper as [107]
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- Authors
- Costa, J., Borges, M., David, C., & Carneiro, A. V.
- Affiliations
- University of Lisbon (PT)
- Hospital de Santa Maria (PT)
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2006-04-03
- Volume
- 332
- Issue
- 7550
- Pages
- 1115-1124
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC1459619
- OpenAlex
- W2141819264
- Cited by
- 340
- References
- 69
- Citations by year
- 2026: 1 · 2025: 14 · 2024: 7 · 2023: 6 · 2022: 13 · 2021: 9 · 2020: 8 · 2019: 8 · 2018: 10 · 2017: 6 · 2016: 12 · 2015: 13 · 2014: 20 · 2013: 24 · 2012: 18
- FWCI
- 7.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
- Keywords
- lipid-lowering drugs, statins, diabetes mellitus, coronary artery disease, major coronary events, primary prevention, secondary prevention, cardiovascular risk reduction, myocardial infarction, coronary revascularization, lipid lowering
- MeSH terms
- Hypolipidemic Agents, Coronary Disease, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Humans, Lipids, Myocardial Infarction, Myocardial Revascularization, Risk Factors, Randomized Controlled Trials as Topic, Treatment Outcome, Dyslipidemias
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