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Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Diabetol+Metab+Syndr 2017 ; 9 (ä): ä Nephropedia Template TP
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Moderate- to high-intensity statins for secondary prevention in patients with type 2 diabetes mellitus on dialysis after acute myocardial infarction #MMPMID28932290
Li YR; Tsai SS; Lin YS; Chung CM; Chen ST; Sun JH; Liou MJ; Chen TH
Diabetol Metab Syndr 2017[]; 9 (ä): ä PMID28932290show ga
Background: Evidences support the benefits of moderate- to high-intensity statins for patients with acute myocardial infarction (AMI) except for those with type 2 diabetes mellitus (T2DM) on dialysis after AMI. This study was aimed to investigate the safety and efficacy of secondary prevention of cardiovascular diseases using moderate- to high-intensity statins in T2DM patients on dialysis after AMI. Methods: A simulated prospective cohort study was conducted between January 1st, 2001 and December 31st, 2013 utilizing data from the Taiwan National Health Insurance Research Database. A total of 882 patients with T2DM on dialysis after AMI were selected as the study cohort. Cardiovascular efficacy and safety of moderate- to high-intensity statins were evaluated by comparing outcomes of 441 subjects receiving statins after AMI to 441 matched subjects not receiving statins after AMI. The primary composite outcome included cardiovascular death, non-fatal myocardial infarction and non-fatal ischemic stroke. Results: The Kaplan?Meier event rate for the primary composite outcomes at 8 years was 30.2% (133 patients) in the statin group compared with 25.2% (111 patients) in the non-statin group (hazard ratio [HR], .98; 95% confidence interval [CI] .76?1.27). Significantly lower risks of non-fatal ischemic stroke (HR, .58; 95% CI .35?.98) and all-cause mortality (HR, .70; 95% CI .59?.84) were found in the statin group. Conclusions: In T2DM patients on dialysis after AMI, the use of moderate- to high-intensity statins has neutral effects on composite cardiovascular events but may reduce risks of non-fatal ischemic stroke and all-cause mortality. Electronic supplementary material: The online version of this article (doi:10.1186/s13098-017-0272-7) contains supplementary material, which is available to authorized users.