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Published on: November 10, 2017

Lipid-modifying therapy in diabetic patients with high plasma non-high-density lipoprotein cholesterol after

Kai Xu1, Ya-Ling Han, Quan-Min Jing

  • 1Department of Cardiology, XiJing Hospital, Fourth Military Medical University XI'AN.

Experimental and Clinical Cardiology
|July 25, 2008
PubMed

Insights

Atorvastatin significantly reduced myocardial infarction and revascularization rates in diabetic patients with high non-HDL-C after PCI. Long-term lipid-modifying therapy is recommended post-procedure for improved outcomes.

Area of Science:

  • Cardiology
  • Pharmacology
  • Diabetology

Background:

  • Diabetic patients with high non-high-density lipoprotein cholesterol (non-HDL-C) face increased cardiovascular risk.
  • Percutaneous coronary intervention (PCI) is a common procedure for coronary artery disease, but long-term prognosis remains a concern in diabetic populations.
  • Effective lipid management is crucial for secondary prevention in these high-risk patients.

Purpose of the Study:

  • To evaluate the long-term impact of atorvastatin on clinical outcomes in diabetic patients with elevated non-HDL-C following successful PCI.
  • To determine if atorvastatin therapy reduces major adverse cardiovascular events compared to no lipid-modifying therapy.

Main Methods:

  • A randomized controlled trial involving 648 diabetic patients with high non-HDL-C post-PCI.
  • Patients were assigned to receive atorvastatin (20 mg/day) or no lipid-modifying therapy.
  • Primary endpoints included all-cause death, myocardial infarction (MI), and revascularization, with a median follow-up of 21 months.

Main Results:

  • Atorvastatin group showed significantly lower rates of MI (6.4% vs. 12.3%) and revascularization (19.2% vs. 26.6%) compared to the control group.
  • A composite endpoint of major adverse cardiovascular events was significantly reduced in the atorvastatin arm (26.9% vs. 41.5%).
  • Adjusted event-free survival was significantly improved with atorvastatin (hazard ratio 0.52, P=0.022), though all-cause mortality was not significantly different.

Conclusions:

  • Long-term lipid-modifying therapy, specifically with atorvastatin, is beneficial for diabetic patients with high non-HDL-C after PCI.
  • Atorvastatin therapy effectively reduces the risk of myocardial infarction and the need for revascularization in this high-risk cohort.
  • These findings support the use of statins for secondary prevention in diabetic patients undergoing PCI.
Abstract

Keywords:
: AtherosclerosisCatheterizationCholesterolDiabetes mellitusStatins

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