Lipid control and use of lipid-regulating drugs for prevention of cardiovascular events in Chinese type 2 diabetic patients: a prospective cohort study
Autor: | Andrea O.Y. Luk, Peter C.Y. Tong, Juliana C.N. Chan, Xilin Yang, Alice P.S. Kong, Linda W.L. Yu, Wing-Yee So, Rose Z.W. Ting, Ronald C.W. Ma |
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Rok vydání: | 2010 |
Předmět: |
Adult
Male China lcsh:Diseases of the circulatory (Cardiovascular) system medicine.medical_specialty Time Factors medicine.drug_class Endocrinology Diabetes and Metabolism Type 2 diabetes Fibrate Risk Assessment Asian People Risk Factors Internal medicine Diabetes mellitus medicine Humans Prospective Studies Registries cardiovascular diseases Risk factor Prospective cohort study Triglycerides Original Investigation Aged Dyslipidemias Proportional Hazards Models Aged 80 and over Fenofibrate business.industry Cholesterol HDL Hazard ratio Cholesterol LDL Middle Aged medicine.disease Lipids Treatment Outcome Diabetes Mellitus Type 2 Cardiovascular Diseases lcsh:RC666-701 Female lipids (amino acids peptides and proteins) Hydroxymethylglutaryl-CoA Reductase Inhibitors Metabolic syndrome Cardiology and Cardiovascular Medicine business Biomarkers medicine.drug |
Zdroj: | Cardiovascular Diabetology, Vol 9, Iss 1, p 77 (2010) Cardiovascular Diabetology |
ISSN: | 1475-2840 |
Popis: | Background Dyslipidaemia is an important but modifiable risk factor of cardiovascular disease (CVD) in type 2 diabetes. Yet, the effectiveness of lipid regulating drugs in Asians is lacking. We examined the effects of lipid control and treatment with lipid regulating drugs on new onset of CVD in Chinese type 2 diabetic patients. Methods In this prospective cohort consisting of 4521 type 2 diabetic patients without history of CVD and naïve for lipid regulating treatment recruited consecutively from 1996 to 2005, 371 developed CVD after a median follow-up of 4.9 years. We used Cox proportional hazard regression to obtain the hazard ratios (HR) of lipids and use of lipid regulating drugs for risk of CVD. Results The multivariate-adjusted HR (95% confidence interval) of CVD in patients with high LDL-cholesterol (≥ 3.0 mmol/L) was 1.36 (1.08 - 1.71), compared with lower values. Using the whole range value of HDL-cholesterol, the risk of CVD was reduced by 41% with every 1 mmol/L increase in HDL-cholesterol. Plasma triglyceride did not predict CVD. Statins use was associated with lower CVD risk [HR = 0.66 (0.50 - 0.88)]. In sub-cohort analysis, statins use was associated with a HR of 0.60 (0.44 - 0.82) in patients with high LDL-cholesterol (≥ 3.0 mmol/L) and 0.49 (0.28 - 0.88) in patients with low HDL-cholesterol. In patients with LDL-cholesterol < 3.0 mmol/L, use of fibrate was associated with HR of 0.34 (0.12 - 1.00). Only statins were effective in reducing incident CVD in patients with metabolic syndrome [(HR = 0.58(0.42--0.80)]. Conclusions In Chinese type 2 diabetic patients, high LDL-cholesterol and low HDL-cholesterol predicted incident CVD. Overall, patients treated with statins had 40-50% risk reduction in CVD compared to non-users. |
Databáze: | OpenAIRE |
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