Model could predict benefits of statins in type 2 diabetes patients

Researchers from The Netherlands have developed a model that can predict the benefits of statin treatment for people with type 2 diabetes.
A team led by Frank Vissere, University Medical Centre Utrecht, analysed data from three major statin trials and created a predictive model based on outcomes of roughly 9,500 patients with type 2 diabetes. The findings appear in the online journal Circulation.
The model is based on eight clinical variables: age, gender, blood pressure, statin treatment, history of cardiovascular disease, smoking status and levels of non-high-density-lipoprotein cholesterol and glucose.
They found the prediction model estimated the median 10-year risk of major cardiovascular events ranged between 15 and 21 per cent among patients not taking statins. The median absolute risk reduction after 10 years of statin treatment was 3.2 per cent.
Visseren’s team reported that the usefulness of the model would depend on a physician’s willingness to prescribe statins.
It would be useful if a physician reserved statin treatment for patients with a 10 per cent risk of cardiovascular benefits over 10 years because 13 per cent of patients would be spared treatment. However, the model would be of no use if a physician routinely prescribed statins.
“Therefore, the additional value of a prediction-based strategy lies in selective treatment of patients in the lower risk groups,” the authors said.
A linked editorial, also published in Circulatio, has questioned these findings. Suzanne Arnold and Mikhail Kosiborod, from Saint Luke’s Mid America Heart Institute and University of Missouri-Kansas City, believe introducing more complexity regarding guideline recommendations and clinical practice can actually cause more problems.
“When the harm in treating a small proportion of additional patients is minimal, it is hard to justify adding further complexity to the current treatment paradigm,” they wrote.