ArticleCardiovascular diabetology2022
Relative contributions of statin intensity, achieved low-density lipoprotein cholesterol level, and statin therapy duration to cardiovascular risk reduction in patients with type 2 diabetes: population based cohort study.
Article in Cardiovascular diabetology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 14 citations in OpenAlex.
- Anti-inflammatory agents in atherosclerosis-and a need for reform: Extraordinary claims require extraordinary evidence.Journal of internal medicine · 2026Article
- The Statin Floor Effect: a Mechanistic Framework for Residual Cardiovascular Risk.Cardiovascular drugs and therapy · 2026Review
- Dyslipidemia in Diabetes: Navigating a Complex Landscape for Improved Cardiovascular Outcomes.Clinical medicine insights. Endocrinology and diabetes · 2026Review
- Myocardial interstitial fibrosis and subclinical left ventricular systolic dysfunction in type 2 diabetes mellitus patients with obesity: a 3.0 T MRI study.Cardiovascular diabetology · 2025Article
- Therapeutic Management of LDL-C: Efficacy and Economic Impact Assessment.Journal of cardiovascular development and disease · 2025Review
- Article
- Risk Factors of Recurrent Stroke in Young and Middle-Aged Stroke Patients after Interventional Therapy.Computational and mathematical methods in medicine · 2022Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCurrent guidelines recommend life-long use of statin for patients with type 2 diabetes (T2D), however, a number of patients discontinue statin therapy in clinical practice. We aimed to estimate the optimal statin therapy including statin therapy duration, statin intensity, and low-density lipoprotein cholesterol (LDL-C) level among patients with T2D in a real-world setting.
methodsFrom Korean National Health Insurance Service Cohort (2007-2015), 8937 patients with T2D (≥ 40 years of age) who received statin therapy for at least 90 days were included. Risk of major adverse cardiovascular event (MACE) including ischemic heart disease, ischemic stroke, and cardiovascular death was estimated according to statin intensity, achieved serum LDL-C level, and statin therapy duration, respectively. The relative contributions of these factors to MACE risk were quantified by calculating the proportion of log-likelihood explained by each factor.
resultsThe hazard ratio (HR) of MACE was lower in patients receiving moderate- or high-intensity statins than in those receiving low-intensity statins (HR, 0.72; p = 0.027). Among patients who received moderate- or high-intensity statins, lower achieved LDL-C level was associated with lower cardiovascular risk. Notably, the longer the patients received statins, the lower was the risk of MACE; the HR of MACE was significantly reduced after at least 18 months (adjusted HR, 0.70; p = 0.009) as a reference to 3-6 months of therapy. The proportion of explainable log-likelihood for MACE was greatest for statin duration (2.55), followed by achieved LDL-C level (2.18), and statin intensity (0.95).
conclusionsStatin therapy duration is as important as or more crucial than statin intensity or achieved LDL-C level for the reduction of cardiovascular risk in T2D patients. The concept of "longer is better" regarding statin therapy should be considered in clinical practice.
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