Statin use and cardiovascular risk factors in diabetic patients developing a first myocardial infarction

摘要

Background The risk for a first myocardial infarction (MI) in people with diabetes has been shown to be as high as the risk for a new MI in non-diabetic patients with a prior MI. Consequently, risk-reducing statin therapy is recommended for nearly all patients with diabetes 40?years of age or older, regardless of cholesterol level. The purpose of this study was to assess the recommended and real-life use of statins for primary prevention of atherosclerotic cardiovascular disease (ASCVD) in diabetic patients who develop ASCVD. Methods In a cross-sectional multicenter study of consecutive patients without previous ASCVD hospitalized with a first MI in 2010–2012, we obtained information on diabetic status, statin use, and cardiovascular risk factors prior to MI. Results The study population consisted of 1622 patients with first MI (63?% men), 228 of whom had known diabetes before MI. All but three of the diabetic patients were ≥40?years of age. Diabetic patients were older (70 vs 68, p?=?0.006), were more often women (43 vs 36?%, p?=?0.05) and had a higher prevalence of statin use (47 vs 11?%, p?Conclusions Primary prevention with statins had been initiated in less than half of diabetic patients destined for a first MI, despite the presence of one or more markers of very high cardiovascular risk in nearly all. These results highlight an urgent need for optimizing statin therapy and global risk factor control in diabetic patients.