Statin Therapy: Diabetes Mellitus Risk and Cardiovascular Benefit in Primary Prevention

Area of Science:

• Cardiology
• Endocrinology
• Pharmacology

Background:

• Statin therapy is beneficial for cardiovascular disease (CVD) but may induce diabetes mellitus (DM).
• Assessing the risk-benefit of statins for CVD prevention regarding DM development is crucial.

Purpose of the Study:

• To evaluate the risk-benefit of statin therapy in the development of diabetes mellitus (DM) for cardiovascular disease (CVD) prevention.

Main Methods:

• A population-based, retrospective study of 265,414 subjects aged 40-70 years.
• Assessed incidence of DM and CVD, considering baseline 10-year cardiovascular risk, statin dose, and adherence.

Main Results:

• Low-intensity statin therapy with >50% adherence increased DM incidence in low/intermediate CV risk patients, without CV benefit in low-risk groups.
• Number Needed to Harm (NNH) for incident DM with low-intensity statins was 40 in low-risk patients.
• Number Needed to Treat (NNT) for CVD was 125 (intermediate risk) and 29 (high risk); NNH for DM was 50 and 200, respectively.

Conclusions:

• Low-dose statins are beneficial for primary CVD prevention in high-risk patients.
• Low-dose statins may be detrimental in low-CV-risk patients due to increased DM incidence.
• Individualized treatment decisions are recommended for intermediate-CV-risk patients receiving statins.