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Statins Reduce Coronary Artery Calcium Progression in Type 2 Diabetes

Definite progression (an annual increase of at least 24%) was more common among untreated patients (41%) than among statin-treated patients (26%). Treatment with statins reduces the progression of coronary artery calcium (CAC), a measure of atherosclerosis, in patients with type 2 diabetes, according to a report by US investigators.

"Aggressive lipid management is important in diabetics, and there is the ability to track atherosclerosis noninvasively to help individualize therapy," Dr. Matthew J. Budoff from Harbor-UCLA Medical Center Research and Education Institute, Torrance, California told Reuters Health.

Dr. Budoff and associates evaluated the rate of progression of CAC in 163 asymptomatic patients with type 2 diabetes, 81 of whom were being treated with statins.

Mean CAC increased 18% per year in patients treated with statins, compared with 32% per year in untreated patients (p = 0.02), the authors report in the April issue of the American Heart Journal. Median increases were similarly different (10% versus 20%, respectively).

Definite progression (an annual increase of at least 24%) was more common among untreated patients (41%) than among statin-treated patients (26%), the report indicates.

In multiple logistic regression, statin use and baseline CAC score were significantly associated with CAC progression, whereas hemoglobin A1c was weakly associated with CAC progression.

"We are now compiling data in a much larger cohort to evaluate whether these findings hold up," Dr. Budoff said. He added that large NIH-sponsored observational studies to evaluate the use and predictive power of CAC in diabetic patients are expected to yield preliminary results within the next year.

"The ability to follow atherosclerosis may be very useful to assess adequacy of therapy," Dr. Budoff concluded. "Sometimes multiple drugs are needed to control lipids and blood pressure, and this tool can potentially help guide physicians."
Am Heart J 2005;149:695-700.

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FACT: Patients treated for a deficiency of iron, B12, or folate can have an inaccurate A1c reading because this can cause a preponderance of red blood cells.
Blood 59:1348-1350, 1982