Table 3.
Estimate of incident DM with low‐, moderate‐, and high‐intensity statin therapy btop panel) and estimates of new‐onset DM (bottom panel)24
| Statin dose decline LDL‐C OR incident DM | Statin intensity (fall LDL‐C, %), [OR, 95% CI] Incident DM | ||
|---|---|---|---|
| Low (20%–30%), 0.98 [0.83–1.16] | Moderate (30%–40%), 1.13 [1.01–1.26] | High (40%–50%), 1.29 [1.13–1.47] | |
| Baseline DM risk/1000 person‐y | Absolute excess risk/1000 person‐y | ||
| 6 | −0.1 (−1.0 to +1.0) | 0.8 (0.1–1.6) | 1.7 (0.8–1.8) |
| 12 | −0.2 (−2.0 to +1.9) | 1.6 (0.1–3.1) | 3.5 (1.6–5.1) |
| 18 | −0.3 (−3.1 to +2.9) | 2.3 (0.2–4.7) | 5.2 (2.3–8.5) |
| Risk group | Statin dose | NOD/1000 patient‐ya | NNH/1000 patient‐y | Statin‐related DMs, No./10 y |
|---|---|---|---|---|
| 2013∅DM ASCVD10 ≥7.5% | Moderate‐high | 2.6 (0.8–4.1)b | 38 (24–100) | 428 373c162 782–678 257 |
| 2016 ASCVD10 ≥10% + 1RF∅DM | Low‐moderate | 0.7 (−0.9 to +2.5)b | 143 (negative 40) | 66 595c(negative 238 077) |
| 2016 ASCVD10 ≥10% + 1RF∅DMd | Low‐moderate | 0.7 (−0.9 to +2.5)b | 143 (negative 40) | 71 038(negative 253 959) |
⊕, with; ∅, without; ASCVD, atherosclerotic cardiovascular disease; CI, confidence interval; LDL‐C, low‐density lipoprotein cholesterol; NA, not applicable (individuals have diabetes mellitus [DM]); negative, ie, lower confidence limit suggests DM prevention with low‐moderate–intensity statins; NNH, number needed to treat; NOD, new‐onset (incident) DM; OR, odds ratio; RF, (cardiovascular) risk factor.
1000 person‐years roughly equivalent to 100 persons × 10 years recognizing that intervention trials included in the analysis ranged from a mean of approximately 2 to 6 years in duration.
Estimate based on incident DM risk of 12/1000 person‐years in an untreated (placebo) group (using data from bold line in upper panel).
Estimate based on the numbers of untreated, statin‐eligible adults without DM by the 2013 guideline (16 278 179) and 2016 (9 523 078) by the 2016 cholesterol guideline.
Hypertension defined by blood pressure ≥130/≥80 mm Hg rather than ≥140/≥90 mm Hg.
Bold line represents data assumptions used to calculate NOD and NNH in lower half