Long-term efficacy of pravastatin therapy in diabetic patients undergoing complete coronary revascularization.
OBJECTIVE
The long-term effect of statin therapy in diabetic patients after coronary revascularization is not well established. Accordingly, we sought to determine if whether statin therapy initiated at the time of complete revascularization including percutaneous coronary intervention (PCI) and/or bypass surgery reduces total and cardiac mortality among diabetic patients.


METHODS
We collected data from 1,138 consecutive patients who underwent complete revascularization (PCI and/or bypass surgery). We then compared all-cause and cardiac mortality rates in 499 patients with diabetes mellitus of whom 149 (29.9%) were treated with statin at the time of revascularization. To adjust the variables that would have been related to the decision regarding statin administration, a propensity score was computed and multivariate Cox regression was carried out.


RESULTS
During follow-up (8.8+/-2.6 years), 103 patients died (including 43 who died of cardiac causes). The Multivariate analysis showed statin therapy to be significantly associated with reduced cardiac mortality (HR 0.39, 0.16-0.95; p=0.039), but not with all-cause mortality.


CONCLUSIONS
Statin therapy was associated with a significantly reduced risk of cardiac mortality in patients with diabetes mellitus and coronary artery disease after complete revascularization.
Department of Cardiovascular Medicine, Juntendo University, School of Medicine, Tokyo, Japan.
Kouichiro
K
Aihara
Katsumi
K
Miyauchi
Takatoshi
T
Kasai
Naozumi
N
Kubota
Kan
K
Kajimoto
Hiroshi
H
Tamura
Takahiko
T
Kojima
Ken
K
Yokoyama
Takeshi
T
Kurata
Atsushi
A
Amano
Hiroyuki
H
Daida
D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000209:etiology* / Q000601:surgery; D048909:Diabetes Complications / Q000188:drug therapy* / Q000473:pathology; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D017035:Pravastatin / Q000627:therapeutic use*; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D017035:Pravastatin