Evidence mapPaperPMID 41444943Full record

ArticleCardiovascular diabetology2025

Cardiovascular outcomes associated with incident diabetes during statin therapy: a nationwide propensity-matched cohort study.

Ki-Chul Sung, Dongwoo Kang, Jungkuk Lee, Seung-Jae Lee, Eun Joo Cho, Jin-Ok Jeong, Moo-Yong Rhee, Da-Eun Sung

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Article in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Ki-Chul Sung *Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-Ro, Jongno-Gu, Seoul, 03181, Republic of Korea. kcmd.sung@samsung.com.
Dongwoo KangData Scientist, Department of Data Science, Hanmi Pharm. Co., Ltd, Seoul, Republic of Korea.
Jungkuk LeeData Scientist, Department of Data Science, Hanmi Pharm. Co., Ltd, Seoul, Republic of Korea.
Seung-Jae LeeDivision of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-Ro, Jongno-Gu, Seoul, 03181, Republic of Korea.
Eun Joo ChoDivision of Cardiology, Department of Internal Medicine, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
Jin-Ok JeongDivision of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea.
Moo-Yong RheeDivision of Cardiology, Dongguk University Ilsan Hospital, Goyang-Si, Gyeonggi, Republic of Korea.
Da-Eun Sung *Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStatins are a cornerstone of cardiovascular disease prevention, but growing evidence suggests they may increase the risk of new-onset type 2 diabetes. The cardiovascular implications of diabetes that develops during statin therapy, however, remain unclear. This study aimed to evaluate whether incident diabetes during statin use is associated with increased risk of major adverse cardiovascular events (MACE) or all-cause mortality, compared with individuals with preexisting diabetes and statin users who remained free of diabetes.

methodsWe conducted two retrospective cohort studies using data from the Korean National Health Insurance Service (KNHIS) database between 2009 and 2020, which includes nationwide, population-based data from both primary and secondary care settings. From a source population of 1,500,959 adults, Study 1 identified 4371 individuals who had used statins continuously for ≥ 730 days before receiving a new diagnosis of type 2 diabetes mellitus (T2DM). These individuals were propensity score-matched 1:1 to individuals who initiated statin therapy after a prior diagnosis of T2DM, matched by age, sex, and low-density lipoprotein cholesterol levels. In Study 2, 4191 statin users who developed T2DM during follow-up were matched 1:1 with statin users who remained diabetes-free during the same period. The primary outcome was MACE, defined as a composite of myocardial infarction and stroke. All-cause mortality was assessed as a secondary outcome.

resultsIn Study 1, individuals who developed diabetes during statin therapy had a significantly lower risk of MACE compared with those who initiated statins after diabetes diagnosis (adjusted hazard ratio [aHR] 0.607; 95% confidence interval [CI], 0.458-0.805; p = 0.0005), primarily driven by a reduced stroke risk (aHR 0.504; 95% CI, 0.357-0.711; p < 0.001). In Study 2, incident diabetes during statin use was not associated with increased risk of MACE (aHR 1.122; 95% CI, 0.784-1.605; p = 0.53) or all-cause mortality (aHR 0.555; 95% CI, 0.290-1.063; p = 0.0758), compared with remaining diabetes-free.

conclusionsDiabetes that develops during statin therapy was associated with a lower risk of MACE compared with initiating statins after diabetes diagnosis and was not linked to increased risk of MACE or all-cause mortality compared with remaining diabetes-free.

Indexed as

Cardiovascular DiseasesDiabetes Mellitus, Type 2DyslipidemiasHydroxymethylglutaryl-CoA Reductase InhibitorsAdultAgedBiomarkersDatabases, FactualFemaleHumansIncidenceMaleMiddle AgedRepublic of KoreaRetrospective StudiesRisk AssessmentBiomarkersHydroxymethylglutaryl-CoA Reductase InhibitorsAll-cause mortalityCardiovascular outcomesCohort studyMajor adverse cardiovascular eventsPropensity score matchingStatinsType 2 diabetes

Identifiers

PMID41444943
PMCPMC12729142

What Socratic holds

Texttitle and abstract
LicenceCC BY-NC-ND
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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.