|  Reuters,
Nov 6, 2006
NEW YORK (Reuters Health) - People with diabetes who have suffered
a heart attack or episode of severe angina -- collectively known
as "acute coronary syndrome" (ACS) -- benefit just as
much from treatment with a so-called statin drug as those without
diabetes, according to an analysis of data from a large statin
treatment trial.
The overall results of the trial, published previously, showed
a drop in cardiovascular complications for all ACS patients treated
with intensive, rather than standard, statin therapy. Examples
of statin drugs include Pravachol, Lipitor, Zocor, or Crestor.
The current subgroup analysis centered on 978 subjects with diabetes
and 3184 without diabetes who were randomized to receive intensive
statin therapy with Zocor, 80 milligrams daily, or standard statin
therapy with 40 mg of Pravachol per day. The average follow-up
period was 24 months.
Consistent with previous reports, diabetics were significantly
more likely than non-diabetics to die during follow-up or experience
a heart attack or angina requiring hospitalization, Dr. Christopher
P. Cannon and colleagues from Harvard Medical School in Boston
report in the European Heart Journal.
However, the magnitude of benefit with intensive rather than
standard statin therapy was comparable in each group.
Still, even with intensive therapy, 62 percent of diabetics did
not lower their LDL or "bad" cholesterol levels as much
as doctors would like.
These results highlight the need for additional risk reduction
strategies in diabetics, the team emphasizes.
SOURCE: European Heart Journal, October 2006.
BBC: Statins for all diabetics urged
BBC,
Jan 2008
People with diabetes should receive cholesterol-busting drugs
regardless of whether they have signs of heart disease, UK researchers
say.
Statins cut the risk of heart attack, stroke and death in diabetic
people even in those with low cholesterol levels, analysis of
14 trials shows.
It means hundreds of thousands more people could benefit from
treatment, the Lancet report said.
There are 2.5 million people diagnosed with diabetes in the UK.
Many more do not realise they have the condition and statins
are "underused" in people with diabetes the researchers
said.
Guidance from the National Institute of Clinical and Health Excellence
(NICE) in England and Wales issued in 2006 estimated around 3.3
million people are eligible for treatment with statins.
This includes people with diabetes who have a 20% risk of developing
cardiovascular disease in the next 10 years.
Benefits
A team of researchers at Oxford
University reviewed studies of more than 90,000 people - 19,000
with diabetes - and found that many more would benefit from statins
than previously realised.
They found that standard daily treatment with statins would prevent
about one third of heart attacks and strokes in people with diabetes.
The benefits were seen regardless of age, sex and whether patients
were already showing signs of cardiovascular disease.
After five years, 42 fewer people with diabetes had major problems,
such as heart attacks or stroke, for every 1,000 treated with
statins.
The only exceptions for treatment should be those with exceptionally
low risk, such as children or those who cannot take the drugs
for other reasons, such as pregnant women.
Study leader Professor Colin Baigent said there had been some
debate about whether statins would have the same benefits in people
with diabetes as those with heart disease in general.
"People with diabetes are a clearly defined group of people
at an increased risk of cardiovascular disease.
"What we're saying is statins are clearly effective in every
type of person with diabetes."
Diabetes UK estimates 60% of all diabetics currently receive
statins. That would mean the vast majority of the remaining 40%
could also benefit from these drugs, according to the researchers.
However, Douglas Smallwood, chief executive of Diabetes UK, recommended
statins for people with diabetes over the age of 40 or diabetics
younger than 40 with another risk factor.
"Diabetes UK also strongly recommends that good diabetes
management should rely not only on medication, but also on a healthy
lifestyle and diet," he added. |
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