Effectiveness and Safety of Statins in Type 2 Diabetes According to Baseline Cardiovascular Risk : A Target Trial Emulation Study
Authors' conclusion
Statin use in T2DM for primary prevention was associated with reductions in all-cause mortality and major CVD across the full spectrum of predicted cardiovascular risk.
Study context
- Population
- Persons aged 25 to 84 years with T2D diagnosed 2005–2016, without coronary artery disease, MI, stroke, HF, myopathy, liver disease, rheumatic heart disease, schizophrenia or cancer; UK primary care (IQVIA Medical Research Data); stratified by QRISK3 10-year predicted cardiovascular disease (CVD) risk: low (<10%), intermediate (10% to 19%), high (20% to 29%), very high (≥30%)
- Exposure
- Statin initiation vs noninitiation
- Outcome
- Absolute risk differences (RDs) and risk ratios (RRs) for all-cause mortality and major CVD, as well as myopathy and liver dysfunction
- Follow-up
- 10 years
Methodological detailspropensity score-matched 1:4 within 4 QRISK3 strata, observational analogue of intention-to-treat effect, Limitations: unmeasured confounding and underascertainment of some hospitalization outcomes
- Propensity score-matched 1:4 within 4 QRISK3 strata
- Observational analogue of intention-to-treat effect
- Limitations: unmeasured confounding and underascertainment of some hospitalization outcomes
Main finding
As reported in the abstract
10 years
Each group vs noninitiationEstimate (95% CI)
Statin initiation
RD (all-cause mortality, low-risk stratum) −0.53 %(−0.90% to −0.08%)
Statin initiation
RD (major CVD, low-risk stratum) −0.83 %(−1.28% to −0.34%)
Each group vs noninitiationEstimate (95% CI)
Statin initiation
RR (all-cause mortality, low-risk stratum) 0.80(0.67–0.97)
Statin initiation
RR (major CVD, low-risk stratum) 0.78(0.66–0.91)
Observational data: associations, not effects.
Safety
- Small increased risk for myopathy in the moderate-risk stratum only
- No associated increased risk for liver dysfunction in any stratum
Original publication
Effectiveness and Safety of Statins in Type 2 Diabetes According to Baseline Cardiovascular Risk : A Target Trial Emulation Study. Ann Intern Med. Published 30 December 2025. doi:10.
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