Evidence mapPaperPMID 40450251Full record

ArticleCardiovascular diabetology2025

Statin-induced risk of diabetes does not reduce cardiovascular benefits in primary prevention: a 6-year propensity-score matched study in a large population.

Maria Lembo, Valentina Trimarco, Raffaele Izzo, Daniela Pacella, Stanislovas S Jankauskas, Paola Gallo, Roberto Piccinocchi, Carmine Morisco, Gaetano Piccinocchi, Luca Bardi and 7 more

Erratum issuedAbstract read
In one paragraph

Article in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Trial
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors.

Maria Lembo *Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy.
Valentina Trimarco *Department of Neuroscience, Reproductive Sciences, and Dentistry, "Federico II" University, Naples, Italy.
Raffaele Izzo *Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy.
Daniela Pacella *Department of Public Health, "Federico II" University, Naples, Italy.
Stanislovas S JankauskasDepartment of Medicine, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Fleischer Institute for Diabetes and Metabolism (FIDAM), Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, New York City, NY, USA.
Paola GalloDepartment of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy.
Roberto Piccinocchi"Luigi Vanvitelli" Hospital, Naples, Italy.
Carmine MoriscoDepartment of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy.
Gaetano PiccinocchiCOMEGEN Primary Care Physician Cooperative, Italian Society of General Medicine (SIMG), Naples, Italy.
Luca BardiDepartment of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy.
Stefano CristianoDepartment of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy.
Giovanni EspositoDepartment of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy.
Giuseppe GiuglianoDepartment of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy.
Fahimeh VarzidehDepartment of Medicine, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Fleischer Institute for Diabetes and Metabolism (FIDAM), Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, New York City, NY, USA.
Maria Virginia ManziDepartment of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy.
Bruno Trimarco *Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy.
Gaetano Santulli *Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy. gsantulli001@gmail.com.ORCID 0000-0001-7231-375X

Funding

Einstein-Montefiore Clinical and Translational Science Award HubUM1TR004400 · ALBERT EINSTEIN COLLEGE OF MEDICINE · 2025 to 2025
$4.3M
REGULATION OF THE INSULIN RECEPTOR KINASER01DK033823 · UNIVERSITY OF IOWA · 1986 to 2004
$1.7M
Mechanisms of cardiovascular diseaseT32HL144456 · NHLBI · ALBERT EINSTEIN COLLEGE OF MEDICINE · 2022 to 2025
$934k
Beta Cell Intracellular Calcium and DiabetesR01DK123259 · NIDDK · ALBERT EINSTEIN COLLEGE OF MEDICINE · PI Gaetano Santulli · 2022 to 2023
$840k
Caspase-9 as a nodal point connecting necrotic and apoptotic cell death in myocardial infarctionR01HL164772 · ALBERT EINSTEIN COLLEGE OF MEDICINE · 2025 to 2025
$622k
Post-doctoral trainee development into independent investigators under senior scientists mentorship (PODIUM)T32HL172255 · ALBERT EINSTEIN COLLEGE OF MEDICINE · 2025 to 2025
$323k
European Commission PNRR-POC-2022-12376833NCATS NIH HHS UL1 TR002556NCATS NIH HHS UM1 TR004400NHLBI NIH HHS R01 HL159062NHLBI NIH HHS R01 HL164772NHLBI NIH HHS R01-HL164772NHLBI NIH HHS T32 HL144456NHLBI NIH HHS T32 HL172255NIDDK NIH HHS R01 DK033823NIDDK NIH HHS R01 DK123259
6 · The paper itself

Abstract

backgroundThe long-term risk of cardiovascular (CV) events in individuals who develop new-onset type 2 diabetes (T2D) after having received statin therapy in primary prevention is mostly unknown.

methodsWe designed a population-based cohort study in individuals without T2D and atherosclerotic CV disease (ASCVD), divided in two groups according to the presence or not of statin therapy. We also balanced the study groups for demographic and clinical factors using propensity score matching.

results119307 individuals without T2D and ASCVD were divided in statin users (N = 90906) or not (N = 28401) and followed-up for 70.1 ± 61.3 months. Yearly incidence of T2D rate was 0.3% in the control group and 2.2% in the statin treated group. A Cox regression analysis confirmed the association between incident T2D and statin therapy. In normotensive individuals, the presence of statin therapy led to a 2-fold risk to develop incident T2D with a HR 2.61 (95% CI 2.11-3.22, p < 0.001) which was also that of statin untreated hypertensive patients. In the hypertensive population statin therapy was associated with a HR of incident T2D of 4.62 (95% CI 3.75-5.69, p < 0.001). CV events rate, including coronary and cerebrovascular fatal and non-fatal events, was 1.9% in the statin group vs. 0.7% in the control group and a multiple regression analysis demonstrated an association between statin therapy and CV events. A further Cox regression performed only in the statin treated population revealed a significant association of CV events with age, serum creatinine levels, and incident T2D. Of note, the increased rate of new-onset T2D associated with statin use does not modify the class of CV risk of this population. All these findings were confirmed at the propensity score matched analysis.

conclusionsStatin therapy in primary prevention is associated with a higher risk of incident T2D, especially in hypertensive patients. However, since the final CV risk of those who develop T2D during statin treatment was lower than the one required for statin prescription according to the ESC guidelines, indicating that this phenomenon does not impair the benefit in CV prevention associated with the lipid lowering effect of statins.

Indexed as

Cardiovascular DiseasesDiabetes Mellitus, Type 2DyslipidemiasHydroxymethylglutaryl-CoA Reductase InhibitorsPrimary PreventionAgedFemaleHumansHypertensionIncidenceMaleMiddle AgedPropensity ScoreProtective FactorsRisk AssessmentRisk FactorsHydroxymethylglutaryl-CoA Reductase Inhibitors

Identifiers

PMID40450251
PMCPMC12125874

What Socratic holds

Texttitle and abstract
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.