Diabetes Care
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pyorala, K.
Right arrow Articles by Thorgeirsson, G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pyorala, K.
Right arrow Articles by Thorgeirsson, G.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

Diabetes Care, Vol 20, Issue 4 614-620, Copyright © 1997 by American Diabetes Association

ARTICLES

Cholesterol lowering with simvastatin improves prognosis of diabetic patients with coronary heart disease. A subgroup analysis of the Scandinavian Simvastatin Survival Study (4S)

K Pyorala, TR Pedersen, J Kjekshus, O Faergeman, AG Olsson and G Thorgeirsson
Department of Medicine, University of Kuopio, Finland.

OBJECTIVE: To assess in diabetic patients with coronary heart disease (CHD) the effect of cholesterol lowering with simvastatin on mortality and the risk of CHD and other atherosclerotic events. RESEARCH DESIGN AND METHODS: A post hoc subgroup analysis was carried out on data from 202 diabetic patients and 4,242 nondiabetic patients with previous myocardial infarction or angina pectoris, serum total cholesterol 5.5-8.0 mmol/l, and serum triglycerides < or = 2.5 mmol/l who were participating in the Scandinavian Simvastatin Survival Study (4S). Participants in the 4S were randomly assigned to double-blind treatment with simvastatin, 20 mg daily, with blinded dosage titration up to 40 mg daily, according to cholesterol response during the first 6-18 weeks, or placebo. Endpoints were 1) total mortality, 2) major CHD events (CHD death or nonfatal myocardial infarction), 3) other acute atherosclerotic events, 4) myocardial revascularization procedures. RESULTS: Over the 5.4-year median follow-up period, simvastatin treatment produced mean changes in serum lipids in diabetic patients similar to those observed in nondiabetic patients. The relative risks (RRs) of main endpoints in simvastatin-treated diabetic patients were as follows: total mortality 0.57 (95% CI, 0.30-1.08; P = 0.087), major CHD events 0.45 (95% CI, 0.27-0.74; P = 0.002), and any atherosclerotic event 0.63 (95% CI, 0.43-0.92; P = 0.018). The corresponding RRs in nondiabetic patients were the following: 0.71 (95% CI, 0.58-0.87; P = 0.001), 0.68 (95% CI, 0.60-0.77; P < 0.0001), and 0.74 (95% CI, 0.68-0.82; P < 0.0001). CONCLUSIONS: The results strongly suggest that cholesterol lowering with simvastatin improves the prognosis of diabetic patients with CHD. The absolute clinical benefit achieved by cholesterol lowering may be greater in diabetic than in nondiabetic patients with CHD because diabetic patients have a higher absolute risk of recurrent CHD events and other atherosclerotic events.
Add to CiteULike CiteULike   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 Arch Intern MedHome page
R. W. Grant, J. S. Wald, J. L. Schnipper, T. K. Gandhi, E. G. Poon, E. J. Orav, D. H. Williams, L. A. Volk, and B. Middleton
Practice-Linked Online Personal Health Records for Type 2 Diabetes Mellitus: A Randomized Controlled Trial
Arch Intern Med, September 8, 2008; 168(16): 1776 - 1782.
[Abstract] [Full Text] [PDF]

Home page
 cfpHome page
B. Patasi and J. R. Conway
Enhancing diabetes care in family practice: A flow sheet
Can Fam Physician, September 1, 2008; 54(9): 1237 - 1238.
[Full Text] [PDF]

Home page
 Diabetes CareHome page
V. A. Fonseca, J. Rosenstock, A. C. Wang, K. E. Truitt, and M. R. Jones
Colesevelam HCl Improves Glycemic Control and Reduces LDL Cholesterol in Patients With Inadequately Controlled Type 2 Diabetes on Sulfonylurea-Based Therapy
Diabetes Care, August 1, 2008; 31(8): 1479 - 1484.
[Abstract] [Full Text] [PDF]

Home page
 J Am Board Fam MedHome page
K. A. Pearce, M. M. Love, B. J. Shelton, N. E. Schoenberg, M. A. Williamson, M. A. Barron, and J. M. Houlihan
Cardiovascular Risk Education and Social Support (CaRESS): Report of a Randomized Controlled Trial from the Kentucky Ambulatory Network (KAN)
J Am Board Fam Med, July 1, 2008; 21(4): 269 - 281.
[Abstract] [Full Text] [PDF]

Home page
 The Diabetes EducatorHome page
J. R. White Jr
Do People With Diabetes Need Statins?
The Diabetes Educator, July 1, 2008; 34(4): 664 - 673.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes Spectr.Home page
B. B. Dokken
The Parodox of Glycemic Control and Cardiovascular Complications: Sorting Out the Data
Diabetes Spectr, July 1, 2008; 21(3): 150 - 152.
[Full Text] [PDF]

Home page
 Diabetes CareHome page
Z. T. Bloomgarden
Cardiovascular Disease in Diabetes
Diabetes Care, June 1, 2008; 31(6): 1260 - 1266.
[Full Text] [PDF]

Home page
 JAOA: Journal of the American Osteopathic AssociationHome page
J. S. Freeman
Treating Hispanic Patients for Type 2 Diabetes Mellitus: Special Considerations
J Am Osteopath Assoc, May 1, 2008; 108(5_suppl_3): S5 - S13.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
J. D. Brunzell, M. Davidson, C. D. Furberg, R. B. Goldberg, B. V. Howard, J. H. Stein, and J. L. Witztum
Lipoprotein Management in Patients With Cardiometabolic Risk: Consensus Conference Report From the American Diabetes Association and the American College of Cardiology Foundation
J. Am. Coll. Cardiol., April 15, 2008; 51(15): 1512 - 1524.
[Full Text] [PDF]

Home page
 JAMAHome page
B. V. Howard, M. J. Roman, R. B. Devereux, J. L. Fleg, J. M. Galloway, J. A. Henderson, Wm. J. Howard, E. T. Lee, M. Mete, B. Poolaw, et al.
Effect of Lower Targets for Blood Pressure and LDL Cholesterol on Atherosclerosis in Diabetes: The SANDS Randomized Trial
JAMA, April 9, 2008; 299(14): 1678 - 1689.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes CareHome page
J. D. Brunzell, M. Davidson, C. D. Furberg, R. B. Goldberg, B. V. Howard, J. H. Stein, and J. L. Witztum
Lipoprotein Management in Patients With Cardiometabolic Risk: Consensus statement from the American Diabetes Association and the American College of Cardiology Foundation
Diabetes Care, April 1, 2008; 31(4): 811 - 822.
[Full Text] [PDF]

Home page
 Diabetes CareHome page
H. Wienbergen, J. Senges, and A. K. Gitt
Should We Prescribe Statin and Aspirin for Every Diabetic Patient?: Is it time for a polypill?
Diabetes Care, February 1, 2008; 31(Supplement_2): S222 - S225.
[Full Text] [PDF]

Home page
 Diabetes CareHome page
G. H. Tomkin
Targets for Intervention in Dyslipidemia in Diabetes
Diabetes Care, February 1, 2008; 31(Supplement_2): S241 - S248.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes CareHome page
American Diabetes Association
Standards of Medical Care in Diabetes--2008
Diabetes Care, January 1, 2008; 31(Supplement_1): S12 - S54.
[Full Text] [PDF]

Home page
 Diabetes Spectr.Home page
P. S. Odegard, S. M. Setter, and J. J. Neumiller
Considerations for the Pharmacological Treatment of Diabetes in Older Adults
Diabetes Spectr, October 1, 2007; 20(4): 239 - 247.
[Full Text] [PDF]

Home page
 Diabetes CareHome page
J. J. Bax, L. H. Young, R. L. Frye, R. O. Bonow, H. O. Steinberg, and E. J. Barrett
Screening for Coronary Artery Disease in Patients With Diabetes
Diabetes Care, October 1, 2007; 30(10): 2729 - 2736.
[Abstract] [Full Text] [PDF]

Home page
 The Diabetes EducatorHome page
L. Kiblinger and N. L. Braza
Diabetes Risk/Improvement Scale
The Diabetes Educator, July 1, 2007; 33(4): 628 - 635.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart J SupplHome page
Authors/Task Force Members, L. Ryden, E. Standl, M. Bartnik, G. V. d. Berghe, J. Betteridge, M.-J. de Boer, F. Cosentino, B. Jonsson, M. Laakso, et al.
Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: full text: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD)
Eur. Heart J. Suppl., June 1, 2007; 9(suppl_C): C3 - C74.
[Full Text] [PDF]

Home page
 Diabetes CareHome page
P. Berikai, P. M. Meyer, R. Kazlauskaite, B. Savoy, K. Kozik, and L. Fogelfeld
Gain in Patients' Knowledge of Diabetes Management Targets Is Associated With Better Glycemic Control
Diabetes Care, June 1, 2007; 30(6): 1587 - 1589.
[Full Text] [PDF]

Home page
 CirculationHome page
C. S. Fox, S. Coady, P. D. Sorlie, R. B. D'Agostino Sr, M. J. Pencina, R. S. Vasan, J. B. Meigs, D. Levy, and P. J. Savage
Increasing Cardiovascular Disease Burden Due to Diabetes Mellitus: The Framingham Heart Study
Circulation, March 27, 2007; 115(12): 1544 - 1550.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
Authors/Task Force Members, L. Ryden, E. Standl, M. Bartnik, G. Van den Berghe, J. Betteridge, M.-J. de Boer, F. Cosentino, B. Jonsson, M. Laakso, et al.
Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD)
Eur. Heart J., January 1, 2007; 28(1): 88 - 136.
[Full Text] [PDF]

Home page
 Ann Fam MedHome page
P. A. Nutting, W. P. Dickinson, L. M. Dickinson, C. C. Nelson, D. K. King, B. F. Crabtree, and R. E. Glasgow
Use of Chronic Care Model Elements Is Associated With Higher-Quality Care for Diabetes
Ann. Fam. Med, January 1, 2007; 5(1): 14 - 20.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes CareHome page
American Diabetes Association
Standards of Medical Care in Diabetes--2007
Diabetes Care, January 1, 2007; 30(suppl_1): S4 - S41.
[Full Text] [PDF]

Home page
 J CARDIOVASC PHARMACOL THERHome page
V. Save, N. Patil, N. Moulik, and G. Rajadhyaksha
Effect of Atorvastatin on Type 2 Diabetic Dyslipidemia
Journal of Cardiovascular Pharmacology and Therapeutics, December 1, 2006; 11(4): 262 - 270.
[Abstract] [PDF]

Home page
 Diabetes CareHome page
D. Rucker, J. A. Johnson, T.K. Lee, D. T. Eurich, R. Z. Lewanczuk, S. H. Simpson, E. L. Toth, and S. R. Majumdar
The Natural History of LDL Control in Type 2 Diabetes: A prospective study of adherence to lipid guidelines.
Diabetes Care, November 1, 2006; 29(11): 2506 - 2508.
[Full Text] [PDF]

Home page
 Eur Heart JHome page
S. Ahmed, C. P. Cannon, S. A. Murphy, and E. Braunwald
Acute coronary syndromes and diabetes: is intensive lipid lowering beneficial? Results of the PROVE IT-TIMI 22 trial
Eur. Heart J., October 1, 2006; 27(19): 2323 - 2329.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart J SupplHome page
C. A. Reasner
Achieving the therapeutic benefits of Niaspan(R) in daily practice
Eur. Heart J. Suppl., October 1, 2006; 8(suppl_F): F68 - F73.
[Abstract] [Full Text] [PDF]

Home page
 CJASNHome page
M. E. Molitch
Management of Dyslipidemias in Patients with Diabetes and Chronic Kidney Disease
Clin. J. Am. Soc. Nephrol., September 1, 2006; 1(5): 1090 - 1099.
[Abstract] [Full Text] [PDF]

Home page
 DTBHome page
Statins for primary prevention in type 2 diabetes
DTB, August 1, 2006; 44(8): 57 - 60.
[Abstract] [Full Text] [PDF]

Home page
 J. Lipid Res.Home page
D. Steinberg
Thematic review series: The Pathogenesis of Atherosclerosis. An interpretive history of the cholesterol controversy, part V: The discovery of the statins and the end of the controversy
J. Lipid Res., July 1, 2006; 47(7): 1339 - 1351.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes CareHome page
R. H. Knopp, M. d'Emden, J. G. Smilde, S. J. Pocock, and on behalf of the ASPEN Study Group
Efficacy and Safety of Atorvastatin in the Prevention of Cardiovascular End Points in Subjects With Type 2 Diabetes: The Atorvastatin Study for Prevention of Coronary Heart Disease Endpoints in Non-Insulin-Dependent Diabetes Mellitus (ASPEN)
Diabetes Care, July 1, 2006; 29(7): 1478 - 1485.
[Abstract] [Full Text] [PDF]

Home page
 The Diabetes EducatorHome page
A. Balasubramanyam, D. Hinnen, and W. Polonsky
Cardiovascular Event Prevention in the Person With Type 2 Diabetes: Case Examples for Identifying and Treating Multiple Risks
The Diabetes Educator, July 1, 2006; 32(Supplement_5): 163S - 173S.
[Full Text] [PDF]

Home page
 Diabetes CareHome page
J. Shepherd, P. Barter, R. Carmena, P. Deedwania, J.-C. Fruchart, S. Haffner, J. Hsia, A. Breazna, J. LaRosa, S. Grundy, et al.
Effect of Lowering LDL Cholesterol Substantially Below Currently Recommended Levels in Patients With Coronary Heart Disease and Diabetes: The Treating to New Targets (TNT) study.
Diabetes Care, June 1, 2006; 29(6): 1220 - 1226.
[Abstract] [Full Text] [PDF]

Home page
 BMJHome page
J. Costa, M. Borges, C. David, and A. Vaz Carneiro
Efficacy of lipid lowering drug treatment for diabetic and non-diabetic patients: meta-analysis of randomised controlled trials
BMJ, May 13, 2006; 332(7550): 1115 - 1124.
[Abstract] [Full Text] [PDF]

Home page
 Journal of Pharmacy PracticeHome page
P. R. Wigle and K. K. Birtcher
What's New? Guidelines and Goals
Journal of Pharmacy Practice, April 1, 2006; 19(2): 103 - 112.
[Abstract] [PDF]

Home page
 CirculationHome page
R. L. Sacco, R. Adams, G. Albers, M. J. Alberts, O. Benavente, K. Furie, L. B. Goldstein, P. Gorelick, J. Halperin, R. Harbaugh, et al.
Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Council on Stroke: Co-Sponsored by the Council on Cardiovascular Radiology and Intervention: The American Academy of Neurology affirms the value of this guideline.
Circulation, March 14, 2006; 113(10): e409 - e449.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
S. P. Marso and W. R. Hiatt
Peripheral Arterial Disease in Patients With Diabetes
J. Am. Coll. Cardiol., March 7, 2006; 47(5): 921 - 929.
[Abstract] [Full Text] [PDF]

Home page
 British Journal of Diabetes & Vascular DiseaseHome page
J. Bottomley, A. J Palmer, R. Williams, J. Dormandy, and M. Massi-Benedetti
Review: PROactive 03: Pioglitazone, type 2 diabetes and reducing macrovascular events -- economic implications?
The British Journal of Diabetes & Vascular Disease, March 1, 2006; 6(2): 63 - 70.
[Abstract] [PDF]

Home page
 British Journal of Diabetes & Vascular DiseaseHome page
A. H Barnett
The challenge of tackling cardiovascular outcomes
The British Journal of Diabetes & Vascular Disease, March 1, 2006; 6(2_suppl): S12 - S16.
[Abstract] [PDF]

Home page
 Diabetes CareHome page
B. V. Howard, L. G. Best, J. M. Galloway, W. J. Howard, K. Jones, E. T. Lee, R. E. Ratner, H. E. Resnick, and R. B. Devereux
Coronary Heart Disease Risk Equivalence in Diabetes Depends on Concomitant Risk Factors
Diabetes Care, February 1, 2006; 29(2): 391 - 397.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
H. N. Ginsberg
REVIEW: Efficacy and Mechanisms of Action of Statins in the Treatment of Diabetic Dyslipidemia
J. Clin. Endocrinol. Metab., February 1, 2006; 91(2): 383 - 392.
[Abstract] [Full Text] [PDF]

Home page
 StrokeHome page
R. L. Sacco, R. Adams, G. Albers, M. J. Alberts, O. Benavente, K. Furie, L. B. Goldstein, P. Gorelick, J. Halperin, R. Harbaugh, et al.
Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Council on Stroke: Co-Sponsored by the Council on Cardiovascular Radiology and Intervention: The American Academy of Neurology affirms the value of this guideline.
Stroke, February 1, 2006; 37(2): 577 - 617.
[Abstract] [Full Text] [PDF]

Home page
 Clin. DiabetesHome page
M. P. Solano and R. B. Goldberg
Lipid Management in Type 2 Diabetes
Clin. Diabetes, January 1, 2006; 24(1): 27 - 32.
[Abstract] [Full Text] [PDF]

Home page
 J. Lipid Res.Home page
W. L. Isley, J. M. Miles, B. W. Patterson, and W. S. Harris
The effect of high-dose simvastatin on triglyceride-rich lipoprotein metabolism in patients with type 2 diabetes mellitus
J. Lipid Res., January 1, 2006; 47(1): 193 - 200.
[Abstract] [Full Text] [PDF]

Home page
 J. Am. Med. Inform. Assoc.Home page
S. Shea, R. S. Weinstock, J. Starren, J. Teresi, W. Palmas, L. Field, P. Morin, R. Goland, R. E. Izquierdo, L. T. Wolff, et al.
A Randomized Trial Comparing Telemedicine Case Management with Usual Care in Older, Ethnically Diverse, Medically Underserved Patients with Diabetes Mellitus
J. Am. Med. Inform. Assoc., January 1, 2006; 13(1): 40 - 51.
[Abstract] [Full Text] [PDF]

Home page
 British Journal of Diabetes & Vascular DiseaseHome page
Evolving treatment paradigms for vascular risk reduction in type 2 diabetes: Report of an international symposium held in Barcelona, Spain, January 27-29, 2006
The British Journal of Diabetes & Vascular Disease, January 1, 2006; 6(1_suppl): S1 - S12.
[PDF]

Home page
 Diabetes CareHome page
American Diabetes Association
Standards of Medical Care in Diabetes-2006
Diabetes Care, January 1, 2006; 29(suppl_1): S4 - S42.
[Full Text] [PDF]

Home page
 CMAJHome page
J. Menard, H. Payette, J.-P. Baillargeon, P. Maheux, S. Lepage, D. Tessier, and J.-L. Ardilouze
Efficacy of intensive multitherapy for patients with type 2 diabetes mellitus: a randomized controlled trial
Can. Med. Assoc. J., December 6, 2005; 173(12): 1457 - 1466.
[Abstract] [Full Text] [PDF]

Home page
 J. Lipid Res.Home page
M. Myerson, C. Ngai, J. Jones, S. Holleran, R. Ramakrishnan, L. Berglund, and H. N. Ginsberg
Treatment with high-dose simvastatin reduces secretion of apolipoprotein B-lipoproteins in patients with diabetic dyslipidemia
J. Lipid Res., December 1, 2005; 46(12): 2735 - 2744.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
Prepared by: British Cardiac Society, British Hype
JBS 2: Joint British Societies' guidelines on prevention of cardiovascular disease in clinical practice
Heart, December 1, 2005; 91(suppl_5): v1 - v52.
[Full Text] [PDF]

Home page
 J. Am. Soc. Nephrol.Home page
M. Tonelli, A. Keech, J. Shepherd, F. Sacks, A. Tonkin, C. Packard, M. Pfeffer, J. Simes, C. Isles, C. Furberg, et al.
Effect of Pravastatin in People with Diabetes and Chronic Kidney Disease
J. Am. Soc. Nephrol., December 1, 2005; 16(12): 3748 - 3754.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
C. P. Cannon
The IDEAL Cholesterol: Lower Is Better
JAMA, November 16, 2005; 294(19): 2492 - 2494.
[Full Text] [PDF]

Home page
 British Journal of Diabetes & Vascular DiseaseHome page
L. F Van Gaal, F. Peiffer, and D. Ballaux
Reducing cardiovascular risk in patients with type 2 diabetes: the potential contribution of nicotinic acid
The British Journal of Diabetes & Vascular Disease, November 1, 2005; 5(6): 344 - 350.
[Abstract] [PDF]

Home page
 Diabetes Spectr.Home page
J. J. Sherman
The Impact of Smoking and Quitting Smoking on Patients With Diabetes
Diabetes Spectr, October 1, 2005; 18(4): 202 - 208.
[Abstract] [Full Text] [PDF]

Home page
 The Annals of PharmacotherapyHome page
B. K Irons and L. A Kroon
Lipid Management with Statins in Type 2 Diabetes Mellitus
Ann. Pharmacother., October 1, 2005; 39(10): 1714 - 1718.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
S. B. King III, G. Dangas, J. W. Moses, S. B. King III, G. Dangas, and J. W. Moses
Surgery Is Preferred for the Diabetic With Multivessel Disease
Circulation, September 6, 2005; 112(10): 1500 - 1515.
[Full Text] [PDF]

Home page
 Am. J. Public HealthHome page
C. Wilson, S. Gilliland, T. Cullen, K. Moore, Y. Roubideaux, L. Valdez, W. Vanderwagen, and K. Acton
Diabetes Outcomes in the Indian Health System During the Era of the Special Diabetes Program for Indians and the Government Performance and Results Act
Am J Public Health, September 1, 2005; 95(9): 1518 - 1522.
[Abstract] [Full Text] [PDF]

Home page