title: Reduction in cardiovascular events with atorvastatin in 2,532 patients with type 2 diabetes: Anglo-Scandinavian Cardiac Outcomes Trial--lipid-lowering arm (ASCOT-LLA).
abstract: OBJECTIVE
  This study aims to establish the benefits of lowering cholesterol in diabetic patients with well-controlled hypertension and average/below-average cholesterol concentrations, but without established coronary disease.
  
  
  METHODS
  In the lipid-lowering arm of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT-LLA), 10,305 hypertensive patients with no history of coronary heart disease (CHD) but at least three cardiovascular risk factors were randomly assigned to receive 10 mg atorvastatin or placebo. Effects on total cardiovascular outcomes in 2,532 patients who had type 2 diabetes at randomization were compared.
  
  
  RESULTS
  During a median follow-up of 3.3 years, concentrations of total and LDL cholesterol among diabetic participants included in ASCOT-LLA were approximately 1 mmol/l lower in those allocated atorvastatin compared with placebo. There were 116 (9.2%) major cardiovascular events or procedures in the atorvastatin group and 151 (11.9%) events in the placebo group (hazard ratio 0.77, 95% CI 0.61-0.98; P = 0.036). For the individual components of this composite end point, the number of events occurring in the diabetes subgroup was small. Therefore, although fewer coronary events (0.84, 0.55-1.29; P = 0.14) and strokes (0.67, 0.41-1.09; P = 0.66) were observed among the patients allocated atorvastatin, these reductions were not statistically significant.
  
  
  CONCLUSIONS
  Atorvastatin significantly reduced the risk of major cardiovascular events and procedures among diabetic patients with well-controlled hypertension and without a history of CHD or markedly elevated cholesterol concentrations. The proportional reduction in risk was similar to that among participants who did not have diagnosed diabetes. Allocation to atorvastatin prevented approximately 9 diabetic participants from suffering a first major cardiovascular event or procedure for every 1,000 treated for 1 year.
authors.affiliation: International Centre for Circulatory Health, NHLI, Faculty of Medicine, Imperial College London, St. Mary's Campus, 59 N. Wharf Road, London W2 1PG, U.K.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Sever
authors.forename: Neil R
authors.initials: NR
authors.lastname: Poulter
authors.forename: Björn
authors.initials: B
authors.lastname: Dahlöf
authors.forename: Hans
authors.initials: H
authors.lastname: Wedel
authors.forename: Rory
authors.initials: R
authors.lastname: Collins
authors.forename: Gareth
authors.initials: G
authors.lastname: Beevers
authors.forename: Mark
authors.initials: M
authors.lastname: Caulfield
authors.forename: Sverre E
authors.initials: SE
authors.lastname: Kjeldsen
authors.forename: Arni
authors.initials: A
authors.lastname: Kristinsson
authors.forename: Gordon T
authors.initials: GT
authors.lastname: McInnes
authors.forename: Jesper
authors.initials: J
authors.lastname: Mehlsen
authors.forename: Markku
authors.initials: M
authors.lastname: Nieminen
authors.forename: Eoin
authors.initials: E
authors.lastname: O'Brien
authors.forename: Jan
authors.initials: J
authors.lastname: Ostergren
mesh_terms: D000328:Adult; D000368:Aged; D000069059:Atorvastatin; D008078:Cholesterol, LDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006538:Heptanoic Acids / Q000008:administration & dosage*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D006949:Hyperlipidemias / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000517:prevention & control; D011758:Pyrroles / Q000008:administration & dosage*; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000517:prevention & control
chemical_list: D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin