Effect of Pitavastatin Compared with Atorvastatin and Rosuvastatin on New-Onset Diabetes Mellitus in Patients With Acute Myocardial Infarction

KAMIR-NIH Investigators

Research output: Contribution to journalArticle

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Abstract

Although statin use in patients with acute myocardial infarction (AMI) is mandatory, it has been suggested to be associated with new-onset diabetes mellitus (NODM). In real world practice, moderate-intensity statin therapy is more commonly used than high-intensity statin therapy. In this study, we investigated the impact of moderate-intensity pitavastatin (2 to 4 mg) compared with moderate-intensity atorvastatin (10 to 20 mg) and rosuvastatin (5 to 10 mg) on the development of NODM during a follow-up period of up to 3 years. Between November 2011 and May 2015, 2001 patients with AMI who did not have diabetes mellitus were investigated. The cumulative incidence of NODM was evaluated in all groups. To adjust for potential confounders, multinomial propensity scores were used. Cox proportional hazard models were used to assess the hazard ratio of NODM in the atorvastatin and rosuvastatin groups compared with pitavastatin group. The cumulative incidence of NODM was significantly lower in pitavastatin group compared with the atorvastatin and rosuvastatin groups (3.0% vs 8.4% vs 10.4%, respectively; Log-rank p value = 0.001). After weighting the baseline characteristics of the 3 statin groups by multinomial propensity scores, atorvastatin (hazard ratio: 2.615, 95% confidence interval: 1.163 to 5.879) and rosuvastatin (hazard ratio: 3.906, 95% confidence interval: 1.756 to 8.688) were found to be associated with a higher incidence of NODM compared with pitavastatin therapy on multivariable analysis. Moderate-intensity pitavastatin therapy is associated with a lower incidence of NODM in patients with AMI and has similar clinical outcomes to moderate-intensity atorvastatin and rosuvastatin therapy.

Original languageEnglish
Pages (from-to)922-928
Number of pages7
JournalAmerican Journal of Cardiology
Volume122
Issue number6
DOIs
Publication statusPublished - 2018 Sep 15

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Diabetes Mellitus
Myocardial Infarction
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Propensity Score
Incidence
Confidence Intervals
Therapeutics
Atorvastatin Calcium
pitavastatin
Rosuvastatin Calcium
Proportional Hazards Models

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Effect of Pitavastatin Compared with Atorvastatin and Rosuvastatin on New-Onset Diabetes Mellitus in Patients With Acute Myocardial Infarction. / KAMIR-NIH Investigators.

In: American Journal of Cardiology, Vol. 122, No. 6, 15.09.2018, p. 922-928.

Research output: Contribution to journalArticle

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abstract = "Although statin use in patients with acute myocardial infarction (AMI) is mandatory, it has been suggested to be associated with new-onset diabetes mellitus (NODM). In real world practice, moderate-intensity statin therapy is more commonly used than high-intensity statin therapy. In this study, we investigated the impact of moderate-intensity pitavastatin (2 to 4 mg) compared with moderate-intensity atorvastatin (10 to 20 mg) and rosuvastatin (5 to 10 mg) on the development of NODM during a follow-up period of up to 3 years. Between November 2011 and May 2015, 2001 patients with AMI who did not have diabetes mellitus were investigated. The cumulative incidence of NODM was evaluated in all groups. To adjust for potential confounders, multinomial propensity scores were used. Cox proportional hazard models were used to assess the hazard ratio of NODM in the atorvastatin and rosuvastatin groups compared with pitavastatin group. The cumulative incidence of NODM was significantly lower in pitavastatin group compared with the atorvastatin and rosuvastatin groups (3.0{\%} vs 8.4{\%} vs 10.4{\%}, respectively; Log-rank p value = 0.001). After weighting the baseline characteristics of the 3 statin groups by multinomial propensity scores, atorvastatin (hazard ratio: 2.615, 95{\%} confidence interval: 1.163 to 5.879) and rosuvastatin (hazard ratio: 3.906, 95{\%} confidence interval: 1.756 to 8.688) were found to be associated with a higher incidence of NODM compared with pitavastatin therapy on multivariable analysis. Moderate-intensity pitavastatin therapy is associated with a lower incidence of NODM in patients with AMI and has similar clinical outcomes to moderate-intensity atorvastatin and rosuvastatin therapy.",
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AU - Hwang, Soon Young

AU - Choi, Byoung Geol

AU - Jang, Won Young

AU - Kim, Do Young

AU - Kim, Woohyeun

AU - Park, Eun Jin

AU - Lee, Sunki

AU - Na, Jin Oh

AU - Kim, Jin Won

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AU - Park, Chang Gyu

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AU - Chae, Sung Chull

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AU - Kim, Chong Jin

AU - Kim, Hyo Soo

AU - Jeong, Myung Ho

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