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Reduction of New Coronary Events and New Atherothrombotic Brain Infarction in Older Persons With Diabetes Mellitus, Prior Myocardial Infarction, and Serum Low-Density Lipoprotein Cholesterol 125 mg/dl Treated With Statins

^a Cardiology Division, Department of Medicine,Westchester Medical Center/New York Medical College, Valhalla
^b Department of Medicine, University of Texas Medical School at Houston
^c Neurocare Associates, Bronx, New York

Wilbert S. Aronow, Cardiology Division, New York Medical College, 23 Pebble Way, New Rochelle, NY 10804 E-mail: WSAronow{at}aol.com.

Background. We report the incidence of new coronary events and new atherothrombotic brain infarction (ABI) in older men and women with diabetes mellitus, prior myocardial infarction, and a serum low-density lipoprotein (LDL) cholesterol of 125 mg/dl treated with statins and with no lipid-lowering drug.

Methods. The incidence of new coronary events and of new ABI was investigated in an observational prospective study of 529 diabetics, mean age 79 ± 9 years, with prior myocardial infarction and a serum LDL cholesterol of 125 mg/dl treated with statins (279 persons or 53%) and no lipid-lowering drug (250 persons or 47%). Follow-up was 29 ± 18 months.

Results. At follow-up, the stepwise Cox regression model showed that after controlling for other risk factors, the use of statins was associated with a 37% significant independent reduction in the incidence of new coronary events and with a 47% significant independent reduction in the incidence of new ABI.

Conclusions. Use of statins was associated with a 37% significant, independent reduction in new coronary events and a 47% significant, independent reduction in new ABI in older men and women with diabetes mellitus, prior myocardial infarction, and a serum LDL cholesterol of 125 mg/dl. Elderly diabetics with prior myocardial infarction and increased serum LDL cholesterol should especially be treated with statins.

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