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

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.