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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Mamdani, Muhammad M. Juurlink, David N. Carter, Aleesa A. Camacho, Ximena Shah, Baiju R. Gomes, Tara |
| Spatial Coverage | Ontario |
| Description | Author Affiliation: Carter AA ( Toronto General Hospital, Toronto, ON, Canada M5G 2C4.); |
| Abstract | Objective To examine the risk of new onset diabetes among patients treated with different HMG-CoA reductase inhibitors (statins). Design Population based cohort study with time to event analyses to estimate the relation between use of particular statins and incident diabetes. Hazard ratios were calculated to determine the effect of dose and type of statin on the risk of incident diabetes. Setting Ontario, Canada. Participants All patients aged 66 or older without diabetes who started treatment with statins from 1 August 1997 to 31 March 2010. The analysis was restricted to new users who had not been prescribed a statin in at least the preceding year. Patients with established diabetes before the start of treatment were excluded. Interventions Treatment with statins. Main outcome measure Incident diabetes. Results Compared with pravastatin (the reference drug in all analyses), there was an increased risk of incident diabetes with atorvastatin (adjusted hazard ratio 1.22, 95% confidence interval 1.15 to 1.29), rosuvastatin (1.18, 1.10 to 1.26), and simvastatin (1.10, 1.04 to 1.17). There was no significantly increased risk among people who received fluvastatin (0.95, 0.81 to 1.11) or lovastatin (0.99, 0.86 to 1.14). The absolute risk for incident diabetes was about 31 and 34 events per 1000 person years for atorvastatin and rosuvastatin, respectively. There was a slightly lower absolute risk with simvastatin (26 outcomes per 1000 person years) compared with pravastatin (23 outcomes per 1000 person years). Our findings were consistent regardless of whether statins were used for primary or secondary prevention of cardiovascular disease. Although similar results were observed when statins were grouped by potency, the risk of incident diabetes associated with use of rosuvastatin became non-significant (adjusted hazard ratio 1.01, 0.94 to 1.09) when dose was taken into account. Conclusions Compared with pravastatin, treatment with higher potency statins, especially atorvastatin and simvastatin, might be associated with an increased risk of new onset diabetes. |
| ISSN | 09598138 |
| e-ISSN | 17561833 |
| Journal | BMJ (British Medical Journal) |
| Volume Number | 346 |
| Language | English |
| Publisher | British Medical Journal Publishing Group |
| Publisher Date | 2013-05-01 |
| Publisher Place | Great Britain (UK) |
| Access Restriction | Open |
| Subject Keyword | Cardiovascular Diseases Prevention & Control Diabetes Mellitus, Type 2 Chemically Induced Dyslipidemias Drug Therapy Hydroxymethylglutaryl-CoA Reductase Inhibitors Administration & Dosage Adverse Effects Atorvastatin Calcium Epidemiology Cohort Studies Etiology Dose-Response Relationship, Drug Fluorobenzenes Heptanoic Acids Odds Ratio Ontario Population Surveillance Pravastatin Proportional Hazards Models Pyrimidines Pyrroles Retrospective Studies Rosuvastatin Calcium Simvastatin Sulfonamides Comparative Study Research Support, Non-U.S. Gov't Medicine |
| Content Type | Text |
| Resource Type | Article |
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