Type 2 diabetes mellitus and atherogenic dyslipidemia: Which statin is most effective in the primary prevention of cardiovascular events?

Background: Type 2 diabetics are at high risk of atherosclerosis and cardiovascular (CV) events due to their associated dyslipidemic profile. Adverse levels of the lipid triad: low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TGs), have bee...

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Main Author: Figg, Gemma
Format: Dissertation (University of Nottingham only)
Language:English
Published: 2012
Online Access:https://eprints.nottingham.ac.uk/26938/
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author Figg, Gemma
author_facet Figg, Gemma
author_sort Figg, Gemma
building Nottingham Research Data Repository
collection Online Access
description Background: Type 2 diabetics are at high risk of atherosclerosis and cardiovascular (CV) events due to their associated dyslipidemic profile. Adverse levels of the lipid triad: low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TGs), have been shown to be major contributing factors. Statins (HMG-CoA reductase inhibitors) are recommended as first-line lipid therapy as evidence has shown their effectiveness in primary and secondary prevention of CV events. However, there is limited evidence specifically focused on primary prevention in type 2 diabetes mellitus (T2DM) and dyslipidemia. Objective: To assess the efficacy of statins in type 2 diabetics with dyslipidemia for the primary prevention of CV events. Methods: A systematic review was carried out to determine the effectiveness of statins in T2DM and dyslipidemia. A comprehensive literature search identified randomised control trials (RCTs) specific to participants with T2DM and dyslipidemia without prior CV events, which investigated the effects of statins on the lipid triad. Bias and quality of the studies were assessed and data extracted was critically analysed. Meta-analyses were carried out to determine the significance of statin effects. Results: 10 RCTs were included investigating the effects of six statins. Statins were shown to improve the lipid triad by lowering LDL-C and TGs and increasing HDL-C, in agreement with previous research. Atorvastatin and rosuvastatin were shown to be most potent in reducing LDL-C and TGs and simvastatin showed the greatest increases in HDL-C. Meta-analyses demonstrated significance favouring statins for LDL-C and TG reductions but less evidence of significant effect of HDL-C VII improvement with all statins. Statins were well tolerated and adverse effects were minimal. Conclusion: Primary prevention in this high risk population is very important. Statins are effective at reducing CV event risk, and nurses should have knowledge of most appropriate statin treatments for patients based on individual lipid levels
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spelling nottingham-269382017-10-19T14:12:20Z https://eprints.nottingham.ac.uk/26938/ Type 2 diabetes mellitus and atherogenic dyslipidemia: Which statin is most effective in the primary prevention of cardiovascular events? Figg, Gemma Background: Type 2 diabetics are at high risk of atherosclerosis and cardiovascular (CV) events due to their associated dyslipidemic profile. Adverse levels of the lipid triad: low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TGs), have been shown to be major contributing factors. Statins (HMG-CoA reductase inhibitors) are recommended as first-line lipid therapy as evidence has shown their effectiveness in primary and secondary prevention of CV events. However, there is limited evidence specifically focused on primary prevention in type 2 diabetes mellitus (T2DM) and dyslipidemia. Objective: To assess the efficacy of statins in type 2 diabetics with dyslipidemia for the primary prevention of CV events. Methods: A systematic review was carried out to determine the effectiveness of statins in T2DM and dyslipidemia. A comprehensive literature search identified randomised control trials (RCTs) specific to participants with T2DM and dyslipidemia without prior CV events, which investigated the effects of statins on the lipid triad. Bias and quality of the studies were assessed and data extracted was critically analysed. Meta-analyses were carried out to determine the significance of statin effects. Results: 10 RCTs were included investigating the effects of six statins. Statins were shown to improve the lipid triad by lowering LDL-C and TGs and increasing HDL-C, in agreement with previous research. Atorvastatin and rosuvastatin were shown to be most potent in reducing LDL-C and TGs and simvastatin showed the greatest increases in HDL-C. Meta-analyses demonstrated significance favouring statins for LDL-C and TG reductions but less evidence of significant effect of HDL-C VII improvement with all statins. Statins were well tolerated and adverse effects were minimal. Conclusion: Primary prevention in this high risk population is very important. Statins are effective at reducing CV event risk, and nurses should have knowledge of most appropriate statin treatments for patients based on individual lipid levels 2012 Dissertation (University of Nottingham only) NonPeerReviewed application/pdf en https://eprints.nottingham.ac.uk/26938/1/CONTENTS_FINAL.pdf Figg, Gemma (2012) Type 2 diabetes mellitus and atherogenic dyslipidemia: Which statin is most effective in the primary prevention of cardiovascular events? [Dissertation (University of Nottingham only)] (Unpublished)
spellingShingle Figg, Gemma
Type 2 diabetes mellitus and atherogenic dyslipidemia: Which statin is most effective in the primary prevention of cardiovascular events?
title Type 2 diabetes mellitus and atherogenic dyslipidemia: Which statin is most effective in the primary prevention of cardiovascular events?
title_full Type 2 diabetes mellitus and atherogenic dyslipidemia: Which statin is most effective in the primary prevention of cardiovascular events?
title_fullStr Type 2 diabetes mellitus and atherogenic dyslipidemia: Which statin is most effective in the primary prevention of cardiovascular events?
title_full_unstemmed Type 2 diabetes mellitus and atherogenic dyslipidemia: Which statin is most effective in the primary prevention of cardiovascular events?
title_short Type 2 diabetes mellitus and atherogenic dyslipidemia: Which statin is most effective in the primary prevention of cardiovascular events?
title_sort type 2 diabetes mellitus and atherogenic dyslipidemia: which statin is most effective in the primary prevention of cardiovascular events?
url https://eprints.nottingham.ac.uk/26938/