Abstract 14894: Strong Statin Treatment Provides Incremental Clinical Benefit In Normocholesterolemic Diabetic Patients With Coronary Heart Disease
Background: Randomized trials established statin as an agent for prevention of coronary heart disease (CHD). We assessed the hypothesis that beneficial effect by statin is different according to the presence of diabetes mellitus (DM) in normocholesterolemic CHD patients.
Methods and Results: A prospective, randomized, open, blinded-endpoint trial was conducted at 55 hospitals in Japan to evaluate the effect of statins on subsequent cardiovascular events. A total number of 1,016 CHD patients (301 patients with type 2 DM and 715 non-DM patients) with serum total cholesterol levels of 180-240 mg/dL were randomly assigned to non-statin and any available statin treatments. Patients with statin therapy were divided into mild statin treatment (n=345) (pravastatin [n=250], simvastatin [n=23], and fluvastatin [n=72]) and strong statin treatment (n=158) (atorvastatin [n=157] and pitavastatin [n=1]) groups. Serum low-density lipoprotein (LDL) cholesterol levels were decreased after strong statin treatment compared with mild statin treatment in DM and non-DM groups (Table). Mild and strong statin treatments improved prognosis especially in DM group, however, the number needed to treat (NNT) and relative risk reduction (RRR) were remarkable in strong statin treatment (NNT=7, RRR=77%) compared with mild statin treatment (NNT=9, RRR=63%) (Figure).
Conclusions: Strong statin treatment provides incremental clinical benefit in DM patients with normal cholesterol levels compared with mild statin treatment. Our findings suggest that DM is a distinctive burden of CHD risk and sufficient reduction of LDL cholesterol levels is recommended even if DM is a single risk factor for CHD.
- © 2011 by American Heart Association, Inc.