Comparative effects of rosuvastatin and atorvastatin on the risk of new-onset diabetes mellitus in patients with acute coronary syndrome receiving percutaneous coronary intervention: a retrospective cohort study

Cunhui Jia, Rui Tian, M. Zong, Fangyun Luan, Wenjun Wang, Chuanbao Li
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Abstract

Abstract Background Statins are frequently prescribed to reduce cardiovascular morbidity and mortality by lowering low-density lipoprotein cholesterol levels. However, the use of statins leads to an increased incidence of new-onset type 2 diabetes mellitus (NODM). Our study aims to compare the effect of rosuvastatin versus atorvastatin on NODM in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI) within 18 months of follow-up. Methods A retrospective cohort study was conducted on patients with ACS who underwent PCI and were treated with rosuvastatin or atorvastatin between June 2012 and June 2017. The survival functions between the 2 groups were estimated using the Kaplan-Meier method and compared using the log-rank test with NODM as the endpoint. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk factors of NODM. Results In total, 220 patients received rosuvastatin and 168 atorvastatin. The cumulative incidence of NODM in the rosuvastatin group was lower but did not reach statistical significance, compared with that in the atorvastatin group (7.27% vs. 12.50%, respectively; log-rank P = 0.08). Using Cox proportional hazards models, baseline fasting blood glucose level was associated with a statistically significant increase in the risk of NODM (HR: 4.56; 95% CI: 2.83–7.36; P < 0.01). Conclusion Long-term use of moderate rosuvastatin had a similar incidence of NODM compared with atorvastatin in patients with ACS receiving PCI.
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瑞舒伐他汀和阿托伐他汀对接受经皮冠状动脉介入治疗的急性冠状动脉综合征患者新发糖尿病风险的比较:一项回顾性队列研究
背景:他汀类药物常被用于降低低密度脂蛋白胆固醇水平,从而降低心血管疾病的发病率和死亡率。然而,他汀类药物的使用导致新发2型糖尿病(NODM)的发病率增加。本研究旨在比较瑞舒伐他汀与阿托伐他汀对急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI) 18个月后NODM的影响。方法回顾性队列研究2012年6月至2017年6月期间接受PCI治疗并接受瑞舒伐他汀或阿托伐他汀治疗的ACS患者。采用Kaplan-Meier法估计两组间的生存函数,并以NODM为终点采用log-rank检验进行比较。采用Cox比例风险模型计算NODM危险因素的风险比(hr)和95%置信区间(ci)。结果220例患者接受瑞舒伐他汀治疗,168例接受阿托伐他汀治疗。瑞舒伐他汀组NODM的累积发生率较阿托伐他汀组低,但未达到统计学意义(分别为7.27% vs 12.50%;log-rank P = 0.08)。使用Cox比例风险模型,基线空腹血糖水平与NODM风险的统计学显著增加相关(HR: 4.56;95% ci: 2.83-7.36;P < 0.01)。结论长期使用中度瑞舒伐他汀与阿托伐他汀治疗ACS PCI患者NODM发生率相似。
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