Effective prevention of cardiovascular disease and diabetes-related events with atorvastatin in Japanese elderly patients with type 2 diabetes mellitus: Adjusting for treatment changes using a marginal structural proportional hazards model and a rank-preserving structural failure time model
Geriatrics and Gerontology International,  Clinical Article

Shinozaki T et al. - The use of atorvastatin to lower cholesterol levels in elderly Japanese patients with type 2 diabetes mellitus appears to reduce the risk of cardiovascular and diabetes-related events.

Methods
  • Data were obtained from 1173 patients aged 65–84 years who were enrolled in the J–EDIT.
  • Patients were followed prospectively for 6 years to determine the effects of atorvastatin on serum cholesterol levels, and cardiovascular and diabetes–related events.
  • Because the study protocol allowed atorvastatin to be prescribed according to the clinical needs of each patient, the authors regarded the J–EDIT data as if they came from a cohort study.
  • The authors adjusted for clinical characteristics during the study as time–dependent confounders using two methods, inverse–probability–of–treatment (IPT) weighting and g–estimation method.
  • The total follow–up period was 5310.8 person–years (5.7 years of median follow up), during which 202 patients received atorvastatin treatment.
  • Atorvastatin was associated with moderate reductions in cholesterol levels: 24.2 mg/dL for total cholesterol, 22.9 mg/dL for low–density lipoprotein (LDL) cholesterol and 24.3 mg/dL for non–high–density lipoprotein cholesterol at the first post–treatment year.

Results
  • As a result, the proportion of patients who achieved targeted levels of LDL cholesterol clearly increased after atorvastatin treatment.
  • Eight patients in 476.6 person–years among atorvastatin–treated and 113 untreated patients in 4721.4 person–years had cardiovascular events (the composite end–point of fatal/non–fatal myocardial infarction, angina pectoris, coronary intervention, and fatal/non–fatal cerebrovascular disease); hazard ratio (HR) = 0.48, 95% confidence interval (CI) = 0.19–1.16, P = 0.10, and HR = 0.32, 95% CI = 0.05–1.87, P = 0.21 from IPT weighting and g–estimation method, respectively.
  • Furthermore, seven in 475.0 person–years among atorvastatin–treated and 149 untreated patients in 4682.4 person–years had diabetes–related events (the composite end–point of sudden death, renal failure death, death as a result of hyperglycemia or hypoglycemia, diabetic gangrene and congestive heart failure in addition to cardiovascular event); HR = 0.30, 95% CI = 0.12–0.77, P = 0.01, and HR = 0.40, 95% CI = 0.09–0.89, P = 0.03 from IPT weighting and g–estimation method, respectively.
  • When cardiovascular events were further differentiated into coronary vascular and cerebrovascular events, atorvastatin especially decreased the cerebrovascular risk.

Please login or register to follow this author.
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Pharmacy

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Pharmacy Articles

1 New drug could make vaccines more effective in the elderly University of Oxford News, November 14, 2014

2 FDA approves new type of sleep drug, Belsomra Full Text FDA Press Announcements, August 14, 2014    Free full text

3 Antibiotic developed 50 years ago may be the key to fighting 'superbugs' University at Buffalo Health and Medicine News, June 19, 2014

4 One injection stops diabetes in its tracks Salk Institute News, July 18, 2014

5 'Unsung' cells double the benefits of a new osteoporosis drug Johns Hopkins Medicine, October 7, 2014

6 New research indicates statin drugs must be taken properly Michigan State University Health News, July 22, 2014

7 Statins reverse learning disabilities caused by genetic disorder UCLA Health System, November 18, 2014

8 UCLA researchers find that drug used for another disease slows progression of Parkinson's UCLA Health System, October 10, 2014

9 Opioid overdose cause for over 100,000 emergency department visits in 2010 Lifespan, November 12, 2014

10 Semen directly impairs effectiveness of microbicides that target HIV Gladstone Institutes News, November 14, 2014

11 Duke team brings life-saving function to ketchup packets Duke University Health & Medicine News, July 3, 2014

12 A new pathway discovered regulating autoimmune diseases Brigham and Women's Hospital, October 9, 2014

13 Effect of ginger (Zingiber officinale) on heavy menstrual bleeding: a placebo-controlled, randomized clinical trial Phytotherapy Research, October 13, 2014    Clinical Article

14 Daily aspirin use and prostate cancer–specific mortality in a large cohort of men with nonmetastatic prostate cancer Journal of Clinical Oncology, October 24, 2014    Clinical Article

15 High-dose dual therapy is superior to standard first-line or rescue therapy for Helicobacter pylori infection Clinical Gastroenterology and Hepatology , November 24, 2014    Clinical Article

16 Ripasudil: first global approval Drugs, November 21, 2014    Clinical Article

17 Effect of prasugrel in patients with asthma: results of PRINA,a randomized, double-blind, placebo-controlled, cross-over study Journal of Thrombosis and Haemostasis, November 25, 2014

18 Nebivolol, but not metoprolol, lowers blood pressure in nitric oxide–sensitive human hypertension Hypertension, November 24, 2014    Clinical Article

19 Magnesium should be given to all children presenting to hospital with acute severe asthma Paediatric Respiratory Reviews, October 15, 2014    Clinical Article

20 Randomized, double-blind trial of anidulafungin versus fluconazole for prophylaxis of invasive fungal infections in high-risk liver transplant recipients American Journal of Transplantation, November 17, 2014    Clinical Article

Indexed Journals in Pharmacy: Expert Opinion in Pharmacotherapy, Formulary, U.S.Pharmacistmore