title: Intensity of statin therapy and new hospitalizations for heart failure in patients with type 2 diabetes.
abstract: OBJECTIVE
  To examine a relationship between statin intensity and heart failure (HF) incidence in diabetes.
  
  
  METHODS
  We performed a retrospective cohort study of patients with type 2 diabetes (n=600; age, 66.3 years; men, 68%). Patients were categorized into three groups by baseline statin treatments-moderate-intensity, low-intensity, or no statin-and the independent association between the statin category and HF hospitalization during follow-up was examined.
  
  
  RESULTS
  Over the course of the median 6-year follow-up, 17.7% of the patients were hospitalized for HF. Cox regression analysis revealed a significant association between the baseline statin category and HF incidence (p=0.002), independently of age, sex, hypertension, B-type natriuretic peptide, glycated hemoglobin, estimated glomerular filtration rate, and low-density lipoprotein (LDL) cholesterol levels. The moderate-intensity statin group had a significantly lower risk for HF than the low-intensity statin group with an adjusted HR of 0.31 (95% CI 0.13 to 0.65, p=0.0014). Interestingly, among patients with prevalent coronary artery diseases (CAD) and with baseline LDL controlled to less than 100 mg/dL, the frequency of HF was still significantly lower in the moderate-intensity group than in the low-intensity group or the no statin group. The effect of baseline statin category on HF was independent of incident CAD events during follow-up.
  
  
  CONCLUSIONS
  In type 2 diabetes, moderate-intensity statins, in comparison to low-intensity or no statin, were associated with lower HF incidence independently of LDL levels or of CAD events.
authors.affiliation: Department of Endocrinology and Metabolism , National Cerebral and Cardiovascular Center , Osaka , Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kishimoto
authors.affiliation: Department of Endocrinology and Metabolism , National Cerebral and Cardiovascular Center , Osaka , Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Makino
authors.affiliation: Department of Endocrinology and Metabolism , National Cerebral and Cardiovascular Center , Osaka , Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Ohata
authors.affiliation: Department of Endocrinology and Metabolism , National Cerebral and Cardiovascular Center , Osaka , Japan.
authors.forename: Tamiko
authors.initials: T
authors.lastname: Tamanaha
authors.affiliation: Department of Endocrinology and Metabolism , National Cerebral and Cardiovascular Center , Osaka , Japan.
authors.forename: Mayu
authors.initials: M
authors.lastname: Tochiya
authors.affiliation: Department of Cardiovascular Medicine , National Cerebral and Cardiovascular Center , Osaka , Japan.
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Anzai
authors.affiliation: Department of Cardiovascular Medicine , National Cerebral and Cardiovascular Center , Osaka , Japan.
authors.forename: Kengo
authors.initials: K
authors.lastname: Kusano
authors.affiliation: Department of Cardiovascular Medicine , National Cerebral and Cardiovascular Center , Osaka , Japan.
authors.forename: Teruo
authors.initials: T
authors.lastname: Noguchi
authors.affiliation: Department of Cardiovascular Medicine , National Cerebral and Cardiovascular Center , Osaka , Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yasuda
authors.affiliation: Department of Cardiovascular Medicine , National Cerebral and Cardiovascular Center , Osaka , Japan.
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
keywords: Cardiovascular Disease Risk; Cholesterol; Coronary Artery Disease; Heart Failure