Cited by 341Lipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and LipoproteinsAntiplatelet Therapy and Cardiovascular Diseases

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Efficacy of lipid lowering drug treatment for diabetic and non-diabetic patients: metaanalysis of randomised controlled trials

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Costa, João, Borges, Margarida, David, Cláudio, Carneiro, António Vaz·2006·BMJ

DOI 10.1136/bmj.38793.468449.aePMC PMC1459619

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Abstract

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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Authors: Costa, J., Borges, M., David, C., & Carneiro, A. V.
Affiliations: University of Lisbon (PT)
Hospital de Santa Maria (PT)
ORCID: Costa, João
Carneiro, António Vaz
Venue: BMJ
Publisher: BMJ
Published: 2006-04-03
Volume: 332
Issue: 7550
Pages: 1115-1124
ISSN: 0007-1447 (ISSN-L)
0959-8138
1468-5833
DOI: 10.1136/bmj.38793.468449.ae
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
Licence: www.bmj.org/licenses/tdm/1.0/terms-and-conditions.html (tdm)
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 › Cardiology and Cardiovascular Medicine › 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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Efficacy of lipid lowering drug treatment for diabetic and non-diabetic patients: metaanalysis of randomised controlled trials

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