Skip to main content
SpringerLink
Log in

Statin Therapy: Impact on Dyslipidemia and Cardiovascular Events in Diabetic Patients

  • Chapter
  • First Online:
Lipoproteins in Diabetes Mellitus

Part of the book series: Contemporary Diabetes ((CDI))

  • 1726 Accesses

Abstract

Diabetes mellitus is associated with high rates of atherosclerosis-related cardiovascular events. Rigorous randomized controlled trials have shown consistently beneficial effects with statin treatment in diabetic patients, reducing event rates. The beneficial effects are seen consistently regardless of pretreatment low-density lipoprotein cholesterol levels. Further reduction of risk with statins may be achieved with more aggressive treatment targeting metrics of atherogenic burden such as apolipoprotein B or LDL particle concentration, more accurately quantifying atherogenic and atherosclerosis-related event risk.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Skalen K, Gustafsson M, Rydberg EK, Hulten LM, Wiklund O, Innerarity TL, et al. Subendothelial retention of atherogenic lipoproteins in early atherosclerosis. Nature. 2002;417(6890):750–4.

    Article  CAS  PubMed  Google Scholar 

  2. Tabas I, Williams KJ, Boren J. Subendothelial lipoprotein retention as the initiating process in atherosclerosis: update and therapeutic implications. Circulation. 2007;116(16):1832–44.

    Article  CAS  PubMed  Google Scholar 

  3. Fruchart JC, Sacks F, Hermans MP, Assmann G, Brown WV, Ceska R, et al. The residual risk reduction initiative: a call to action to reduce residual vascular risk in patients with dyslipidemia. Am J Cardiol. 2008;102(10 Suppl):1K–34.

    Article  PubMed  Google Scholar 

  4. Sniderman A, Williams K, de Graaf J. Non-HDL C equals apolipoprotein B: except when it does not! Curr Opin Lipidol. 2010;21(6):518–24.

    Article  CAS  PubMed  Google Scholar 

  5. Kastelein JJ, van der Steeg WA, Holme I, Gaffney M, Cater NB, Barter P, et al. Lipids, apolipoproteins, and their ratios in relation to cardiovascular events with statin treatment. Circulation. 2008;117(23): 3002–9.

    Article  CAS  PubMed  Google Scholar 

  6. Sniderman A, Solhpour A. Targeting targets for LDL-lowering therapy: lessons from the Collaborative Atorvastatin Diabetes Study (CARDS). Clin Chem. 2009;55(3):391–3.

    Article  CAS  PubMed  Google Scholar 

  7. Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet. 2002; 360(9326):7–22.

    Article  Google Scholar 

  8. Collins R, Armitage J, Parish S, Sleigh P, Peto R. MRC/BHF Heart Protection Study of cholesterol-lowering with simvastatin in 5963 people with diabetes: a randomised placebo-controlled trial. Lancet. 2003;361(9374):2005–16.

    Article  PubMed  Google Scholar 

  9. Sever PS, Dahlof B, Poulter NR, Wedel H, Beevers G, Caulfield M, et al. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the anglo-scandinavian cardiac outcomes trial-lipid lowering arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet. 2003;361(9364):1149–58.

    Article  CAS  PubMed  Google Scholar 

  10. Sever PS, Poulter NR, Dahlof B, Wedel H, Collins R, Beevers G, et al. Reduction in cardiovascular events with atorvastatin in 2,532 patients with type 2 diabetes: anglo-scandinavian cardiac outcomes trial–lipid-lowering arm (ASCOT-LLA). Diabetes Care. 2005;28(5):1151–7.

    Article  CAS  PubMed  Google Scholar 

  11. Colhoun HM, Betteridge DJ, Durrington PN, Hitman GA, Neil HA, Livingstone SJ, et al. Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the collaborative atorvastatin diabetes study (CARDS): multicentre randomised placebo-controlled trial. Lancet. 2004;364(9435):685–96.

    Article  CAS  PubMed  Google Scholar 

  12. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in moderately hypercholesterolemic, hypertensive patients randomized to pravastatin vs usual care: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT). JAMA. 2002;288(23):2998–3007.

    Article  Google Scholar 

  13. Kearney PM, Blackwell L, Collins R, Keech A, Simes J, Peto R, et al. Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis. Lancet. 2008; 371(9607):117–25.

    Article  CAS  PubMed  Google Scholar 

  14. Ridker PM, MacFadyen JG, Fonseca FA, Genest J, Gotto AM, Kastelein JJ, et al. Number needed to treat with rosuvastatin to prevent first cardiovascular events and death among men and women with low low-density lipoprotein cholesterol and elevated high-sensitivity C-reactive protein: justification for the use of statins in prevention: an intervention trial evaluating rosuvastatin (JUPITER). Circ Cardiovasc Qual Outcomes. 2009;2(6):616–23.

    Article  PubMed  Google Scholar 

  15. Mihaylova B, Briggs A, Armitage J, Parish S, Gray A, Collins R. Lifetime cost effectiveness of simvastatin in a range of risk groups and age groups derived from a randomised trial of 20,536 people. BMJ. 2006; 333(7579):1145.

    Article  PubMed  Google Scholar 

  16. Gaede P, Lund-Andersen H, Parving HH, Pedersen O. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 2008;358(6):580–91.

    Article  CAS  PubMed  Google Scholar 

  17. de Graaf J, Couture P, Sniderman A. A diagnostic algorithm for the atherogenic apolipoprotein B dyslipoproteinemias. Nat Clin Pract Endocrinol Metab. 2008;4(11):608–18.

    Article  PubMed  Google Scholar 

  18. Grundy SM, Cleeman JI, Merz CN, Brewer Jr HB, Clark LT, Hunninghake DB, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation. 2004;110(2):227–39.

    Article  PubMed  Google Scholar 

  19. Otvos JD, Mora S, Shalaurova I, Greenland P, Mackey RH, Goff Jr DC. Clinical implications of discordance between low-density lipoprotein cholesterol and particle number. J Clin Lipidol. 2011;5(2):105–13.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Sniderman AD, Williams K, Contois JH, Monroe HM, McQueen MJ, de Graaf J, et al. A meta-analysis of low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B as markers of cardiovascular risk. Circ Cardiovasc Qual Outcomes. 2011;4(3):337–45.

    Article  PubMed  Google Scholar 

  21. Davidson MH, Ballantyne CM, Jacobson TA, Bittner VA, Braun LT, Brown AS, et al. Clinical utility of inflammatory markers and advanced lipoprotein testing: advice from an expert panel of lipid specialists. J Clin Lipidol. 2011;5(5):338–67.

    Article  PubMed  Google Scholar 

  22. Brunzell JD, Davidson M, Furberg CD, Goldberg RB, Howard BV, Stein JH, et al. Lipoprotein management in patients with cardiometabolic risk: consensus conference report from the American Diabetes Association and the American College of Cardiology Foundation. J Am Coll Cardiol. 2008;51(15):1512–24.

    Article  PubMed  Google Scholar 

  23. Gotto Jr AM, Whitney E, Stein EA, Shapiro DR, Clearfield M, Weis S, et al. Relation between baseline and on-treatment lipid parameters and first acute major coronary events in the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS). Circulation. 2000;101(5):477–84.

    Article  CAS  PubMed  Google Scholar 

  24. Sattar N, Preiss D, Murray HM, Welsh P, Buckley BM, de Craen AJ, Seshasai SR, et al. Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials. Lancet. 2010;375:735–42.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Johns Hopkins University, Baltimore, MD, USA

    Seth S. Martin & Parag H. Joshi

  2. Department of Medicine, Cardiology Division, The Johns Hopkins Hospital, Zayed 7125U, 1800 Orleans Street, Baltimore, MD, 21287, USA

    Steven R. Jones M.D.

Authors
  1. Seth S. Martin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Parag H. Joshi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Steven R. Jones M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Steven R. Jones M.D. .

Editor information

Editors and Affiliations

  1. NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia

    Alicia J. Jenkins

  2. College of Medicine, University of Illinois, Peoria, Illinois, USA

    Peter P. Toth

  3. Section of Endocrinology and Diabetes Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA

    Timothy J. Lyons

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Martin, S.S., Joshi, P.H., Jones, S.R. (2014). Statin Therapy: Impact on Dyslipidemia and Cardiovascular Events in Diabetic Patients. In: Jenkins, A., Toth, P., Lyons, T. (eds) Lipoproteins in Diabetes Mellitus. Contemporary Diabetes. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4614-7554-5_18

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-7554-5_18

  • Published:

  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4614-7553-8

  • Online ISBN: 978-1-4614-7554-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation