Issue 38 December 2011
4. Proof of effectiveness of Statin in prolonged study

Statins are medications used to lower cholesterol and is part of a standard type 2 diabetes prescription. New study results shows that lowering LDL cholesterol with statins reduces vascular morbidity and mortality rapidly. This large randomised trial conducted on 20,536 patients at high risk of vascular and non-vascular outcomes were allocated either 40 mg simvastatin daily or placebo, using minimised randomisation. The importance was that here the mean in-trial follow-up was 5•3 years (SD 1•2), and post-trial follow-up of surviving patients yielded a mean total duration of 11•0 years (SD 0•6). During the in-trial period, allocation to simvastatin yielded an average reduction in LDL cholesterol of 1•0 mmol/L and a proportional decrease in major vascular events of 23% (95% CI 19—28; p<0•0001), with significant divergence each year after the first. During the post-trial period (when statin use and lipid concentrations were similar in both groups), no further significant reductions were noted in either major vascular events (risk ratio [RR] 0•95 [0•89—1•02]) or vascular mortality (0•98 [0•90—1•07]). The researchers concludes that more prolonged LDL-lowering statin treatment produces larger absolute reductions in vascular events

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