title: Statins for primary prevention of cardiovascular and cerebrovascular events in diabetic patients without established cardiovascular diseases: a meta-analysis.
abstract: OBJECTIVE
  Lipid-lowering medications could lead to a significant reduction in major cardiovascular events in patients with diabetes. However, there was still controversy regarding the use of statins in patients with diabetes for primary prevention. The meta-analysis was performed to evaluate the outcomes of statin-therapy in diabetic patients without established cardiovascular diseases.
  
  
  METHODS
  7 randomized controlled trials of statin- vs. control-therapy in patients with diabetes were included. A total number of 12,711 patients were involved. The outcomes of interest were major adverse cardiovascular and cerebrovascular events (MACCE), including myocardial infarction, stroke, all-cause mortality and coronary revascularization.
  
  
  RESULTS
  A total of 1,376 MACCE occurred during follow-up, with 9.54% (605 patients) in the statin therapy group and 12.10% (771 patients) in control group. Statin therapy was associated with a significant reduction in the incidence of MACCE (0.79, 95%CI 0.66-0.95; P=0.01). Meanwhile, the risk of stroke and coronary revascularization were reduced 29 and 26% in statin therapy group. However, there was no statistical difference of all-cause mortality between statin- and control-therapy group (3.73 vs. 4.65%, P=0.13).
  
  
  CONCLUSIONS
  For primary prevention in patients with diabetes without established cardiovascular disease, statin therapy could reduce the cardiovascular and cerebrovascular events, but not all-cause mortality.
authors.affiliation: Department of Endocrinology, East Hospital, Tongji University, Shanghai, PR China.
authors.forename: Y-H
authors.initials: YH
authors.lastname: Chen
authors.forename: B
authors.initials: B
authors.lastname: Feng
authors.forename: Z-W
authors.initials: ZW
authors.lastname: Chen
mesh_terms: D000924:Anticholesteremic Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002423:Cause of Death; D002561:Cerebrovascular Disorders / Q000517:prevention & control*; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000401:mortality; D003925:Diabetic Angiopathies / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D000924:Anticholesteremic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors