Cardiovascular disease (CVD) is the leading cause of death among people with diabetes. Despite the known benefits of statins in reducing this risk, many patients are reluctant to start statin therapy due to concerns about side effects and other factors. This reluctance can have serious consequences, as shown by a recent retrospective cohort study that examined the impact of delaying statin therapy on cardiovascular outcomes.

      The study focused on 7,239 people with type 2 diabetes who had no prior history of atherosclerotic cardiovascular disease (ASCVD). Researchers analyzed the relationship between delayed statin therapy—due to patients initially declining the treatment—and the incidence of cardiovascular events such as heart attacks (MI) or ischemic strokes. Data on statin non-acceptance and baseline characteristics were sourced from electronic medical records.

      At the start of the study, the mean LDL-C (bad cholesterol) level was 138 mg/dl (SD 28), and the mean HbA1c (a measure of blood glucose control) was 7.5% (SD 1.9). Out of the total participants, 1,280 (17.7%) delayed starting statin therapy by an average of 2.7 years (SD 3.1), despite having an average of 4.6 provider visits (SD 9.1) during that time. Once these patients began statin therapy, they continued for an average of 7.1 years (SD 4.8).

      Over an average follow-up period of 8.2 years (SD 4.6), 455 patients (6.3%) experienced a cardiovascular event. When comparing the two groups, 6.4% (95% CI 5.6-7.2) of patients who accepted statin therapy had a cardiovascular event within 10 years, compared to 8.5% (95% CI 6.8-10.5) of those who initially declined the therapy (p = 0.001).

      The study's findings highlight a critical issue: people with diabetes who delay statin therapy due to initial non-acceptance face a significantly higher risk of cardiovascular events. This underscores the importance of addressing patient concerns about statins and encouraging timely initiation of therapy to reduce the risk of heart attacks and strokes.