Statins for Primary Prevention of Cardiovascular and Cerebrovascular Events in Diabetic Patients without Established Cardiovascular Diseases: A Meta-Analysis

Aims: Lipid-lowering medications could lead to a significant reduction in major cardiovascular events in patients with diabetes. However, there was still controversy regarding the use of statins in patients with diabetes for primary prevention. The meta-analysis was performed to evaluate the outcomes of statin-therapy in diabetic patients without established cardiovascular diseases. Methods: 7 randomized controlled trials of statin-vs. control-therapy in patients with diabetes were included. A total number of 12 711 patients were involved. The outcomes of interest were major adverse cardiovascular and cerebrovascular events (MACCE), including myocardial infarction, stroke, all-cause mortality and coronary revascularization. Results: A total of 1 376 MACCE occurred during follow-up, with 9.54 % (605 patients) in the statin therapy group and 12.10 % (771 patients) in control group. Statin therapy was associated with a significant reduction in the incidence of MACCE (0.79, 95 % CI 0.66-0.95; P = 0.01). Meanwhile, the risk of stroke and coronary revascularization were reduced 29 and 26 % in statin therapy group. However, there was no statistical difference of all-cause mortality between statin- and control-therapy group (3.73 vs. 4.65 %, P = 0.13). Conclusions: For primary prevention in patients with diabetes without established cardiovascular disease, statin therapy could reduce the cardiovascular and cerebrovascular events, but not all-cause mortality.