Language
English
Publication Date
12-1-2022
Journal
The American Journal of Cardiology
DOI
10.1016/j.amjcard.2022.08.040
PMID
36192199
PMCID
PMC10458502
PubMedCentral® Posted Date
8-26-2023
PubMedCentral® Full Text Version
Author MSS
Abstract
Although there is a significant reduction in atherosclerotic cardiovascular disease risk with statins, a higher risk of diabetes mellitus has been demonstrated in randomized clinical trials. The risk of incident diabetes with statins may be heterogeneous by presence of coronary artery calcium (CAC). We evaluated participants without prevalent diabetes at baseline from the MESA (Multi-Ethnic Study of Atherosclerosis), a prospective cohort study of subjects free of clinical cardiovascular disease at baseline. We used multivariable-adjusted Cox proportional hazards models to study the association between statin use and incident diabetes, adjusting for sociodemographic and cardiovascular risk factors, including time-varying statin use and stratifying by baseline CAC (0, 1 to 100, ≥100). The study population included 5,943 participants with a mean (SD) age of 62 (10) years, 54% women, 41% White, 26% Black, 12% Chinese-American, and 21% Hispanic. In the unadjusted analyses, statin use was associated with a higher risk of incident diabetes (hazard ratio [HR] 1.62, 95% confidence interval [CI] 1.27 to 2.06). After adjustment, this risk was no longer significant (HR 1.13, 95% CI 0.83 to 1.54). Although imprecise, the HR expressing the association of statins with diabetes was lower for those with CAC = 0 (HR 0.80, 95% CI 0.45 to 1.40) than for those with a higher CAC burden (HR 1.30, 95% CI 0.71 to 2.39 for CAC 1 to 100 and HR 1.39, 95% CI 0.85 to 2.28 for CAC ≥100), but this heterogeneity was not statistically significant. In conclusion, statin therapy was not significantly associated with incident diabetes mellitus in this observational study. The risk of incident diabetes did not significantly differ by baseline CAC.
Keywords
Humans, Female, Middle Aged, Male, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Vascular Calcification, Coronary Artery Disease, Prospective Studies, Cardiovascular Diseases, Risk Factors, Atherosclerosis, Diabetes Mellitus, Calcium
Published Open-Access
yes
Recommended Citation
Al Rifai, Mahmoud; Szklo, Moyses; Patel, Jaideep; et al., "Statin Use and Risk of Diabetes by Subclinical Atherosclerosis Burden (from a Multi-Ethnic Study of Atherosclerosis Report)" (2022). Faculty and Staff Publications. 4313.
https://digitalcommons.library.tmc.edu/baylor_docs/4313