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Lipid-lowering therapy reduces risk for CVD, death in type 1 diabetes
People with type 1 diabetes without a history of cardiovascular disease may have reduced risk for cardiovascular disease and cardiovascular death with the use of lipid-lowering therapy, according to study findings.
“The risk of all-cause death and stroke in the overall cohort was almost halved for persons on [lipid-lowering therapy],” the researchers wrote.
Christel Hero, MD, of Sahlgrenska University Hospital in Gothenburg, Sweden, and colleagues evaluated data from the Swedish National Diabetes Register from 2006 to 2008 on 24,230 people with type 1 diabetes and no history of CVD. Mean follow-up was 6 years.
Of the participants, 18,843 were untreated and 5,387 were prescribed lipid-lowering therapy (97% statins). Researchers sought to determine the effect of lipid-lowering therapies in primary prevention on CVD and death in people with type 1 diabetes.
A roughly four times higher crude event rate was found in the treatment group compared with the untreated group for the overall cohort.
In a one-to-one matched cohort of 4,025 patients treated with lipid-lowering therapy (treatment group) treatment and 4,025 untreated patients, there were 18.2 fatal/nonfatal CVD events per 1,000 person-years in the treatment group vs. 17.3 in the untreated group. However, all-cause death was lower in the treatment group (9.9 deaths per 1,000 person-years) compared with the untreated group (13.2 per 1,000 person-years).
In the overall cohort, the HRs for the treatment group compared with the untreated group were significant for CV death (HR = 0.6; 95% CI, 0.5-0.72), all-cause death (HR = 0.56; 95% CI, 0.48-0.64), fatal/nonfatal stroke (HR = 0.56; 95% CI, 0.46-0.7), fatal/nonfatal acute myocardial infarction (HR = 0.78; 95% CI, 0.66-0.92) and fatal/nonfatal coronary heart disease (HR = 0.85; 95% CI, 0.74-0.97). In the matched cohort, the HR was significant only for all-cause death (HR = 0.74; 95% CI, 0.62-0.88).
“This observational study showed that [lipid-lowering therapy] is associated with 22% to 44% reduction in the risk of CVD and [CV] death among individuals with type 1 diabetes without history of CVD,” the researchers wrote. “This is the first large observational study underlining the importance of intervention with [lipid-lowering therapy] in primary prevention to reduce [CV] risk in type 1 diabetes.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.