PMID- 23460659
OWN - NLM
STAT- MEDLINE
DCOM- 20151112
LR  - 20161125
IS  - 2047-4881 (Electronic)
IS  - 2047-4873 (Linking)
VI  - 21
IP  - 7
DP  - 2014 Jul
TI  - Association of a reduction in low-density lipoprotein cholesterol with incident 
      cardiovascular and cerebrovascular events among people with type 2 diabetes 
      mellitus.
PG  - 855-65
LID - 10.1177/2047487313481752 [doi]
AB  - BACKGROUND: Although there is overwhelming evidence that reducing low-density 
      lipoprotein cholesterol (LDL-C) with statins leads to reductions in 
      cardiovascular disease, less is known about the effects in persons with type 2 
      diabetes mellitus (T2DM) without pre-existing vascular events. METHODS AND 
      RESULTS: Using the UK-based General Practice Research Database we conducted a 
      retrospective cohort study of 21,998 T2DM patients aged 35-69 with >/=2 
      prescriptions for lipid-modifying therapy (2000-2009). We categorized LDL-C 
      change (mmol/l) between last available and baseline lipid values as reduction 
      (>/=3.0, 2.0-2.9, 1.0-1.9, 0.3-0.9), no-change (+/-0.2 of baseline), or increase 
      (>0.2). Outcomes were incident composite cardiovascular (n = 621) and 
      cerebrovascular events (n = 274). We estimated hazard ratios (HRs) of study 
      outcomes and 95% confidence intervals (CIs) for LDL-C change compared with the 
      no-change group. Compared to no changes, adjusted HRs of cardiovascular events 
      for a reduction >/=3.0 and a reduction between 2.0-2.9 were 0.41 (95% CI: 
      0.23-0.71) and 0.51 (95% CI: 0.34-0.76) (p for linear trend <0.001). LDL-C 
      reduction yielded a decreased cerebrovascular event risk compared to no change, 
      even with the smallest reduction (adjusted HR = 0.59, 95% CI: 0.36-0.98). 
      CONCLUSIONS: Decreasing LDL-C is associated with a reduced risk of cardiovascular 
      and cerebrovascular events among T2DM patients without such pre-existing events. 
      The magnitude of the protective effect on cerebrovascular events is less certain, 
      and further studies are warranted.
CI  - (c) The European Society of Cardiology 2013 Reprints and permissions: 
      sagepub.co.uk/journalsPermissions.nav.
FAU - Li, Lin
AU  - Li L
AD  - Boston Collaborative Drug Surveillance Program, Boston University, School of 
      Public Health, USA.
FAU - Ambegaonkar, Baishali M
AU  - Ambegaonkar BM
AD  - Global Health Outcomes, Merck & Co. Inc. Whitehouse Station, USA.
FAU - Reckless, John P D
AU  - Reckless JP
AD  - Royal United Hospital Bath NHS Trust, UK.
FAU - Jick, Susan
AU  - Jick S
AD  - Boston Collaborative Drug Surveillance Program, Boston University, School of 
      Public Health, USA sjick@bu.edu.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130304
PL  - England
TA  - Eur J Prev Cardiol
JT  - European journal of preventive cardiology
JID - 101564430
RN  - 0 (Cholesterol, LDL)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cardiovascular Diseases/blood/*complications/epidemiology
MH  - Cholesterol, LDL/*blood
MH  - Cohort Studies
MH  - Diabetes Mellitus, Type 2/blood/*complications
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Stroke/blood/*complications/epidemiology
MH  - United Kingdom
OTO - NOTNLM
OT  - Low-density lipoprotein cholesterol
OT  - cardiovascular events
OT  - cerebrovascular events
OT  - type 2 diabetes mellitus
EDAT- 2013/03/06 06:00
MHDA- 2015/11/13 06:00
CRDT- 2013/03/06 06:00
PHST- 2013/03/06 06:00 [entrez]
PHST- 2013/03/06 06:00 [pubmed]
PHST- 2015/11/13 06:00 [medline]
AID - 2047487313481752 [pii]
AID - 10.1177/2047487313481752 [doi]
PST - ppublish
SO  - Eur J Prev Cardiol. 2014 Jul;21(7):855-65. doi: 10.1177/2047487313481752. Epub 
      2013 Mar 4.