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Patients with diabetes who start statins promptly reduce their chances of experiencing myocardial infarction (MI) and ischemic stroke by one third compared with people who delay taking the medication, American researchers say.

The researchers used artificial intelligence (AI) to gather data from the health records of 7,239 patients with diabetes who started a statin. Patients were an average of 55 years old and their median HbA1c was 6.9 per cent. Of these, 17.7 per cent initially declined statins but accepted the therapy after a mean delay of 2.7 years. 

Over 10 years, 6.4 per cent of patients who started statins immediately and 8.5 per cent of patients who delayed therapy had a MI or ischemic stroke.

Adjusting for demographics and comorbidities, delaying statins increased the risk of these cardiovascular events considered together by 49 per cent. Looked at separately, delaying statins increased MI by 53 per cent and ischemic stroke by 42 per cent.

Patients who delayed statins had higher mean low density lipoprotein (LDL) cholesterol levels while they were not taking statins (126.4 and 99.2mg/dL respectively). Greater LDL cholesterol exposure resulting from delaying statins increased the rate of adverse cardiovascular events by 62 per cent. 

Further research is needed to examine the reasons for statin non-acceptance and to identify factors that encourage early uptake of the drugs. 

“Clinicians should recognise the increased cardiovascular risk associated with delaying statin therapy for patients with diabetes and use this information to guide shared decision-making conversations with their patients,” says senior author Alexander Turchin of Brigham and Women’s Hospital, Boston. 

Some people refuse because they want to first try lifestyle interventions or other drugs. But other interventions are not as effective at lowering cholesterol as starting statin therapy as soon as possible. Time is of the essence for 
your heart and brain health.”