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Diabetes Research Highlights: Statins and Coronary Collateral Development

Strategic Insights

— 2 min read

Research from Turkey, Italy, and the United States has shed light on the impact of statins on diabetic patients, particularly in relation to coronary collateral development. A study in the American Journal of Cardiology found that statin treatment and stable angina pectoris are associated with better coronary collateral development in patients with diabetes mellitus. Another study in the Journal of the American College of Cardiology evaluated screening guidelines for coronary artery disease in asymptomatic patients with type 2 diabetes mellitus and found that an aggressive diagnostic approach can identify patients with subclinical CAD and favorable angiographic anatomy. Meanwhile, a study in the Journal of Lipid Research discovered that statin use is related to increased LPL activity and results in accelerated delipidation of triglyceride particles.

Key Takeaways:

  • Statin treatment and stable angina pectoris are associated with better coronary collateral development in patients with diabetes mellitus (Effect of statin treatment on coronary collateral development in patients with diabetes mellitus. Am J Cardiol, 2006;97(6):772-774).
  • An aggressive diagnostic approach, requiring coronary angiography in asymptomatic DM2 patients with less than or equal to1 associated RF for CAD, can identify patients with a subclinical CAD characterized by a more favorable angiographic anatomy (Detection of coronary artery disease in asymptomatic patients with type 2 diabetes mellitus. J Am Coll Cardiol, 2006;47(1):65-71).
  • Statin use is related to increased LPL activity, resulting in accelerated delipidation of triglyceride particles (The effect of high-dose simvastatin on triglyceride-rich lipoprotein metabolism in patients with type 2 diabetes mellitus. J Lipid Res, 2006;47(1):193-200).
  • I. Dincer and colleagues from Turkey studied 149 diabetic patients and found that statin therapy and stable angina pectoris were independent predictors of better collateral formation.
  • R. Scognamiglio and colleagues from Italy evaluated 1,899 asymptomatic DM2 patients and found that an 'aggressive' diagnostic approach can identify patients with a subclinical CAD characterized by a more favorable angiographic anatomy.
  • W.L. Isley and colleagues from the United States discovered that simvastatin therapy reduced serum TGs by 35% in diabetic subjects and increased TRL-TG clearance.
  • The studies highlight the importance of statins in managing diabetic patients and the need for aggressive diagnostic approaches to identify CAD in asymptomatic patients.

Statistics:

  • 74 of 149 patients in the Turkish study were receiving statin treatment.
  • The prevalence of abnormal NICE and significant CAD was similar in the two study groups in the Italian study (59.4 vs. 60%, p=0.96 and 64.6 vs. 65.5%, p=0.92, respectively).
  • TRL-TG secretion was almost 2-fold higher in diabetic subjects compared to control subjects (45.4[+ or -]4.9 vs. 24.4[+ or -]1.9 mcmol/min).
  • TRL-TG clearance was significantly increased in diabetic subjects during simvastatin treatment compared to placebo (0.25[+ or -]0.03 vs. 0.16[+ or -]0.02 pools/h).

Sources:

  • Dincer, I., et al. "Effect of statin treatment on coronary collateral development in patients with diabetes mellitus." American Journal of Cardiology (2006);97(6):772-774.
  • Scognamiglio, R., et al. "Detection of coronary artery disease in asymptomatic patients with type 2 diabetes mellitus." Journal of the American College of Cardiology (2006);47(1):65-71.
  • Isley, W.L., et al. "The effect of high-dose simvastatin on triglyceride-rich lipoprotein metabolism in patients with type 2 diabetes mellitus." Journal of Lipid Research (2006);47(1):193-200.

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