• Po-Hsun Chen, Jun-Sing Wang, Shih-Yi Lin, Cheng-Hung Li, Chi-Yen Wang, Ching-Yun Hu, Chia-Po- Fu, Yi-Ting Tsai, Ang-Tse Lee, Yu-Wei Chen, Yu-Hsuan Li, and Chia-Lin Lee.
• a Department of Internal Medicine , Taichung Veterans General Hospital, Chiayi branch , Chiayi , Taiwan.
• Curr Med Res Opin. 2018 Nov 1; 34 (11): 188518921885-1892.

ObjectiveTo investigate the effects of statins on all-cause mortality risk at different low-density lipoprotein cholesterol (LDL-C) levels, and to compare the mortality risk between statin users and non-users with identical LDL-C levels in a type 2 diabetes cohort.MethodsIn total, 10,582 outpatients aged ≥18 years with type 2 diabetes mellitus (T2DM) between 2009 and 2012 were enrolled in this retrospective cohort study in central Taiwan. All-cause mortality events were followed up until the end of 2014. According to the medical records during the follow-up period, the patients were classified into statin (+) and statin (-) groups. Patients were categorized into different LDL-C segments based on their mean LDL-C levels during the 2.8-year follow-up.ResultsNon-cardiovascular mortality accounted for more than half the deaths. Overall, statin therapy significantly reduced the all-cause mortality risk in both univariable and multivariable models (hazard ratios = 0.39 and 0.38, respectively). Sub-group analyses showed that the lowest mortality risk occurred in the 80-89 mg/dL segment in the statin (-) group and in the 90-99 mg/dL segment in the statin (+) group. Statin therapy significantly reduced the mortality risk at all LDL-C levels except for low LDL-C (<60 mg/dL).ConclusionsIn addition to reducing LDL-C levels, statin therapy reduced all-cause mortality risk in Taiwanese patients with T2DM. Statins further reduced the mortality risk at most LDL levels. However, at low LDL-C levels, the positive effects of statins may have been nullified.

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