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    Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials.

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    Authors
    Sattar, Naveed
    Preiss, David
    Murray, Heather M
    Welsh, Paul
    Buckley, Brendan M
    de Craen, Anton J M
    Seshasai, Sreenivasa Rao Kondapally
    McMurray, John J
    Freeman, Dilys J
    Jukema, J Wouter
    Macfarlane, Peter W
    Packard, Chris J
    Stott, David J
    Westendorp, Rudi G
    Shepherd, James
    Davis, Barry R
    Pressel, Sara L
    Marchioli, Roberto
    Marfisi, Rosa Maria
    Maggioni, Aldo P
    Tavazzi, Luigi
    Tognoni, Gianni
    Kjekshus, John
    Pedersen, Terje R
    Cook, Thomas J
    Gotto, Antonio M
    Clearfield, Michael B
    Downs, John R
    Nakamura, Haruo
    Ohashi, Yasuo
    Mizuno, Kyoichi
    Ray, Kausik K
    Ford, Ian
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    Affiliation
    British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK. nsattar@clinmed.gla.ac.uk
    Issue Date
    2010-02-27
    MeSH
    Age Distribution
    Age Factors
    Aged
    Anticholesteremic Agents
    Cardiovascular Diseases
    Diabetes Mellitus, Type 2
    Female
    Humans
    Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Male
    Middle Aged
    Randomized Controlled Trials as Topic
    Risk Factors
    Treatment Outcome
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    Citation
    Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials. 2010, 375 (9716):735-42 Lancet
    Publisher
    Elsevier
    Journal
    Lancet
    URI
    http://hdl.handle.net/10147/200331
    DOI
    10.1016/S0140-6736(09)61965-6
    PubMed ID
    20167359
    Abstract
    Trials of statin therapy have had conflicting findings on the risk of development of diabetes mellitus in patients given statins. We aimed to establish by a meta-analysis of published and unpublished data whether any relation exists between statin use and development of diabetes.
    We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials from 1994 to 2009, for randomised controlled endpoint trials of statins. We included only trials with more than 1000 patients, with identical follow-up in both groups and duration of more than 1 year. We excluded trials of patients with organ transplants or who needed haemodialysis. We used the I(2) statistic to measure heterogeneity between trials and calculated risk estimates for incident diabetes with random-effect meta-analysis.
    We identified 13 statin trials with 91 140 participants, of whom 4278 (2226 assigned statins and 2052 assigned control treatment) developed diabetes during a mean of 4 years. Statin therapy was associated with a 9% increased risk for incident diabetes (odds ratio [OR] 1.09; 95% CI 1.02-1.17), with little heterogeneity (I(2)=11%) between trials. Meta-regression showed that risk of development of diabetes with statins was highest in trials with older participants, but neither baseline body-mass index nor change in LDL-cholesterol concentrations accounted for residual variation in risk. Treatment of 255 (95% CI 150-852) patients with statins for 4 years resulted in one extra case of diabetes.
    Statin therapy is associated with a slightly increased risk of development of diabetes, but the risk is low both in absolute terms and when compared with the reduction in coronary events. Clinical practice in patients with moderate or high cardiovascular risk or existing cardiovascular disease should not change.
    None.
    Item Type
    Article
    Language
    en
    ISSN
    1474-547X
    ae974a485f413a2113503eed53cd6c53
    10.1016/S0140-6736(09)61965-6
    Scopus Count
    Collections
    Cork University Hospital

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