The Association of Statins for Secondary Prevention With Progression to Diabetes in Patients With Prediabetic State After Coronary Artery Bypass Graft Surgery: A Retrospective Cohort Study Publisher Pubmed



Poorhosseini H¹ ; Tavolinejad H¹ ; Aminorroaya A^{1, 2} ; Soleimani H¹ ; Aasham O¹ ; Jalali A¹ ; Mohammadi A¹ ; Beigi SS¹ ; Sadeghian S¹ ; Bagheri J¹ ; Tajdini M¹ Show Affiliations
Source: Journal of Diabetes and its Complications Published:2020

Abstract

Aim: Despite proven benefits of statins for secondary prevention of coronary artery diseases, their diabetogenic effect is still controversial. We aimed to examine the occurrence of type 2 diabetes mellitus (T2DM) in prediabetic patients after coronary artery bypass grafting (CABG). Methods: The retrospective cohort population comprised of post-CABG patients who were prediabetic at the time of surgery and were taking statins. Patients were categorized into the high- and low-intensity statin regimens according to the commonly used dose during the follow-up. Moreover, we calculated the cumulative dose (milligrams*days) by taking into account that patients were on different doses of statins during different periods of time. We observed patients for occurrence of T2DM or major adverse cardiovascular events (MACE) as a composite of death, myocardial infarction, cerebrovascular accident, and hospitalization for unstable angina or heart failure. Results: We studied 819 patients for a median of 37.8 months after CABG. T2DM occurred in 8.1% (n = 66). The rate of T2DM development was not different between the high- and low-intensity groups (P = 0.715) and also according to the cumulative dose (P = 0.962). Furthermore, we found no association (P = 0.938) even after adjustment for confounders including age, sex, body mass index, alcohol use, history of hypertension and hyperlipidemia, and family history of T2DM. Moreover, high- rather than low-intensity statin regimen was correlated with a lower occurrence of MACE (P = 0.027), even after adjustment for confounders (P = 0.015). Conclusions: In prediabetic post-CABG patients, treatment with statins was not associated with the development of T2DM and reduced occurrence of MACE after 37 months. © 2020 Elsevier Inc.