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Diabetes mellitus and cardiovascular events in older patients with myocardial infarction prescribed intensive-dose and moderate-dose statins.
- Source :
-
Circulation. Cardiovascular quality and outcomes [Circ Cardiovasc Qual Outcomes] 2013 May 01; Vol. 6 (3), pp. 315-22. Date of Electronic Publication: 2013 May 14. - Publication Year :
- 2013
-
Abstract
- Background: Practice guidelines recommend intensive-dose statins for patients with acute coronary syndrome, but recent data about the risk of new-onset diabetes mellitus have raised concerns about its use. Our main objective was to evaluate the association between intensive statin therapy and new-onset diabetes mellitus in patients with myocardial infarction and to evaluate the association of intensive statin therapy with long-term adverse clinical outcomes.<br />Methods and Results: A propensity score-matched cohort was created consisting of 17 080 patients with myocardial infarction aged >65 years old, hospitalized in Ontario, Canada, from 2004 to 2010. Clinical outcomes were compared in patients prescribed intensive-dose versus moderate-dose statins at hospital discharge. At 5 years, 13.6% of patients receiving intensive-dose statins and 13.0% of patients receiving moderate-dose statins had new-onset diabetes, which was not significantly different (P=0.19). By contrast, the 5-year rate of death or acute coronary syndrome was significantly lower at 44.8% in the intensive-dose statin group compared with 46.5% in the moderate-dose group (P=0.044). The reduction in combined clinical outcome was driven mainly by a significantly lower rate of acute coronary syndrome (P=0.039) associated with intensive-dose statins. No significant difference in mortality rates (34.8% in both groups) was observed between the treatment groups during the study period (P=0.89).<br />Conclusions: In older patients with myocardial infarction, we found intensive-dose statin therapy to be effective in reducing repeat hospitalization for acute coronary syndrome. The rate of new-onset diabetes mellitus at long term was not significantly different between intensive-dose and moderate-dose statins.
- Subjects :
- Acute Coronary Syndrome diagnosis
Acute Coronary Syndrome mortality
Age Factors
Aged
Aged, 80 and over
Cohort Studies
Comorbidity
Diabetes Mellitus diagnosis
Diabetes Mellitus mortality
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors administration & dosage
Incidence
Kaplan-Meier Estimate
Male
Myocardial Infarction diagnosis
Myocardial Infarction mortality
Ontario epidemiology
Patient Discharge
Patient Readmission
Propensity Score
Risk Assessment
Risk Factors
Secondary Prevention
Time Factors
Treatment Outcome
Acute Coronary Syndrome drug therapy
Diabetes Mellitus chemically induced
Hydroxymethylglutaryl-CoA Reductase Inhibitors adverse effects
Myocardial Infarction drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1941-7705
- Volume :
- 6
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Circulation. Cardiovascular quality and outcomes
- Publication Type :
- Academic Journal
- Accession number :
- 23674307
- Full Text :
- https://doi.org/10.1161/CIRCOUTCOMES.111.000015