EBM COMMENTARY
SHOULD STATINS BE STARTED IN ALL TYPE 2 DIABETICS IRRESPECTIVE OF LDL-CHOLESTEROL LEVEL?
Table 1: Summary of randomised controlled trials and meta-analyses evaluating the efficacy of statin therapy in preventing major cardiovascular events* in patients with diabetes but without overt coronary artery disease
| Study (year) | Intervention | Control | RRR, % (95%CI) | ARR, % (95%CI | NNT |
| Randomised controlled trials | |||||
HPS3 (2003) |
13.8% | 18.6% | 35 (18-52) |
4.8 (2.5 to 7.1) | 21 (14-40) |
CARDS4 (2004) |
5.8% | 9.0% | 51 (18-84) |
3.0 (1.1 to 5.0) | 33 (20-92) |
ASPEN5 (2006) |
10.4% | 10.8% | 3 (-28 to 26) | Not applicable | Not applicable |
| Meta-analyses | |||||
| Vijan6 (2004) | 22 (11 to 33) | 3 (1 to 4) | 33 (25-100) | ||
| Thavendiranathan7 (2006) | 29 (17 to 40) | NA | NA | ||
* Major cardiovascular events include any of the following: acute coronary syndrome, stroke, coronary revascularisation
HPS: n=5963 type 2 diabetes (age 40-80 years, mean LDL-C 3.0 mmol/L), simvastatin 40 mg daily vs placebo for about 4.8 years.
CARDS: n=2838 patients with type 2 diabetes (age 40-80 years, mean LDL-C 3.0 mmol/L) atorvastatin 10 mg daily vs placebo (this trial was terminated at 2 years because the prespecified early stopping rule for efficacy had been met).
ASPEN: n=2410 patients with type 2 diabetes (mean age 60 years, mean LDL-C 3.0 mmol/L), atorvastatin 10 mg daily vs placebo for 4 years.
NA, not available