Diabetes, Arterial Calcification and Statin Drugs

George is a 54 year old diabetic on statin drug for coronary artery disease. Five years ago, George had an episode of chest pain, which prompted a cardiac cath, during which a stent was placed in the LAD (left anterior descending). Even though George’s total cholesterol has always been normal (200), George’s cardiologist placed him on simvastatin, a statin drug to lower his cholesterol. However, George has been reading about statins and he wants to stop taking the drug. Above image showing calcified coronary arteries on CAT scan courtesy of Hecht 2015.

Apparently, George discovered that statin drugs are ineffective for primary prevention of heart disease in healthy people, nor do they reduce mortality from heart disease in selected populations such as women, the elderly, renal dialysis, and COPD patients. Statins do not reduce mortality in primary prevention studies (in healthy populations), and seem to have the best effects in secondary prevention, ie in patients with known heart disease. George wants to know if he really needs the statin drug, and “is it OK to stop taking it?” See Statin Drugs Revisited

Statins are Effective in Diabetic Populations

That brings us to the question of “what is the efficacy of statin drugs in the Diabetic population?” Lucky for us, this question has been studied and answered by a number of randomized trials. Statin use in Diabetics (even with normal cholesterol levels) reduces cardiovascular events and cardiovascular mortality by 20-30 per cent compared to placebo treated diabetics. (68-70) In addition, Statin therapy reduces amputation rate in diabetics by 25%.(28) Notice the statin recommendation in Diabetics is made even with normal cholesterol levels.

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