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Cited by 313Lipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and LipoproteinsCancer, Lipids, and Metabolism

Secondary Prevention of Cardiovascular Events With Long-Term Pravastatin in Patients With Diabetes or Impaired Fasting Glucose

Open access
Keech, Anthony, Colquhoun, David, Best, James, Kirby, Adrienne, Simes, R. John, Hunt, David, Hague, Wendy, Beller, Elaine +4 more·2003·Diabetes Care
DOI 10.2337/diacare.26.10.2713
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Abstract

OBJECTIVE—Diabetes, a major health problem worldwide, increases the risk of cardiovascular disease and its associated mortality. Evidence of the overall benefits of lipid modification in this area is needed. RESEARCH DESIGN AND METHODS—The Long-Term Intervention with Pravastatin in Ischemic Disease (LIPID) trial showed that cholesterol-lowering treatment with pravastatin reduced mortality and coronary heart disease (CHD) events in 9,014 patients aged 31–75 years with CHD and total cholesterol 4.0–7.0 mmol/l. We measured the effects of pravastatin therapy, 40 mg/day over 6.0 years, on the risk of CHD death or nonfatal myocardial infarction and other cardiovascular outcomes in 1,077 LIPID patients with diabetes and 940 patients with impaired fasting glucose (IFG). RESULTS—In patients allocated to placebo, the risk of a major CHD event was 61% higher in patients with diabetes and 23% higher in the IFG group than in patients with normal fasting glucose, and the risk of any cardiovascular event was 37% higher in the diabetic group and 19% higher in the IFG group. Pravastatin therapy reduced the risk of a major CHD event overall from 15.9 to 12.3% (relative risk reduction [RRR] 24%, P < 0.001) and from 23.4 to 19.6% in the diabetic group (19%, P = 0.11); in the diabetic group, the reduction was not significantly different from the reductions in the other groups. Pravastatin reduced the risk of any cardiovascular event from 52.7 to 45.2% (21%, P < 0.008) in patients with diabetes and from 45.7 to 37.1% (26%, P = 0.003) in the IFG group. Pravastatin reduced the risk of stroke from 9.9 to 6.3% in the diabetic group (RRR 39%, CI 7–61%, P = 0.02) and from 5.4 to 3.4% in the IFG group (RRR 42%, CI −9 to 69%, P = 0.09). Pravastatin did not reduce the incidence of diabetes. Over 6 years, pravastatin therapy prevented one major CHD event (CHD death or nonfatal myocardial infarction) in 23 patients with IFG and 18 patients with diabetes. A meta-analysis of other major trials confirmed the high absolute risks of diabetes and IFG and the absolute benefits of statin therapy in these patients. CONCLUSIONS—Cholesterol-lowering treatment with pravastatin therapy prevents cardiovascular events, including stroke, in patients with diabetes or IFG and established CHD.

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  • Statins remain first-line therapy for patients with hypertriglyceridemia, having demonstrated consistent reductions in ASCVD events across a wide range of populations, including those with elevated triglycerides.

    “Statins remain the first-line therapy for patients with hypertriglyceridemia, having demonstrated consistent reductions in ASCVD events across a wide range of populations, including those with elevated triglycerides.”

    From Targeting Triglycerides in Cardiovascular Disease Prevention: Evidence, Mechanisms, and Emerging Therapies (2026) · cites this paper as [83]

  • Subgroup data from LIPID trial showed significant benefit in patients with diabetes and mixed dyslipidemia, many of whom had elevated TG levels.

    “Subgroup data from the LIPID trial further showed significant benefit in patients with diabetes and mixed dyslipidemia, many of whom had elevated TG levels [83].”

    From Targeting Triglycerides in Cardiovascular Disease Prevention: Evidence, Mechanisms, and Emerging Therapies (2026) · cites this paper as [83]

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Authors
Keech, A., Colquhoun, D., Best, J., Kirby, A., Simes, R. J., Hunt, D., Hague, W., Beller, E., Arulchelvam, M., Baker, J., Tonkin, A., & for the LIPID Study Group
Affiliations
  • The University of Sydney (AU)
  • Wesley Hospital (AU)
  • St Vincent's Hospital Melbourne (AU)
  • The Royal Melbourne Hospital (AU)
  • National Heart Foundation of Australia (AU)
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2003-10-01
Volume
26
Issue
10
Pages
2713-2721
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/diacare.26.10.2713
OpenAlex
W2086139919
Cited by
313
References
36
Citations by year
2026: 4 · 2024: 3 · 2023: 5 · 2022: 6 · 2021: 5 · 2020: 3 · 2019: 11 · 2018: 7 · 2017: 6 · 2016: 11 · 2015: 13 · 2014: 14 · 2013: 21 · 2012: 14
FWCI
26.36
Type
journal article
Language
en
Open access
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
  • Griffith Research Online (submittedVersion)
Funders
  • Bristol-Myers Squibb
  • National Heart Foundation of Australia
  • Medical Research Council
  • National Health and Medical Research Council
Topics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
Keywords
pravastatin, secondary prevention, cardiovascular events, diabetes mellitus, impaired fasting glucose, coronary artery disease, myocardial infarction, stroke, LIPID trial, cholesterol-lowering therapy, statins, cardiovascular risk reduction, hypercholesterolemia, diabetes incidence, nonfatal myocardial infarction, cardiovascular hospitalization
MeSH terms
Adult, Aged, Angina, Unstable, Anticholesteremic Agents, Blood Glucose, Cardiovascular Diseases, Coronary Artery Disease, Diabetes Mellitus, Type 2, Fasting, Female, Follow-Up Studies, Humans, Hyperlipidemias, Male, Middle Aged, Myocardial Infarction, Risk Factors, Treatment Outcome, Pravastatin, Glucose Intolerance, Stroke, Coronary Restenosis

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