Remo Holanda de Mendonça Furtado et al. Paulo Rizzo Genestreti Talia F. Dalçóquio Luciano Moreira Baracioli … Felipe Galego Lima André Franci Roberto R. C. V. Giraldez Fernando R. Menezes Aline Gehlen Ferrari Viviane Moreira Lima Cesar A. C. Pereira Carlos Alberto Kenji Nakashima Rocio Salsoso Lucas Colombo Godoy José C. Nicolau
Abstract
Background
Increased risk of new-onset diabetes with statins challenges the long-term safety of this drug class. However, few reports have analyzed this issue during acute coronary syndromes (ACS).
Objective
To explore the association between early initiation of statin therapy and blood glucose levels in patients admitted with ACS.
Methods
This was a retrospective analysis of patients hospitalized with ACS. Statin-naïve patients were included and divided according to their use or not of statins within the first 24 hours of hospitalization. The primary endpoint was incidence of in-hospital hyperglycemia (defined as peak blood glucose > 200 mg/dL). Multivariable linear and logistic regression models were used to adjust for confounders, and a propensity-score matching model was developed to further compare both groups of interest. A p-value of less than 0.05 was considered statistically significant.
Results
A total of 2,357 patients were included, 1,704 of them allocated in the statin group and 653 in the non-statin group. After adjustments, statin use in the first 24 hours was associated with a lower incidence of in-hospital hyperglycemia (adjusted OR=0.61, 95% CI 0.46-0.80; p < 0.001) and lower need for insulin therapy (adjusted OR = 0.56, 95% CI 0.41-0.76; p < 0.001). These associations remained similar in the propensity-score matching models, as well as after several sensitivity analyses, such as after excluding patients who developed cardiogenic shock, severe infection or who died during index-hospitalization.
Conclusions
Among statin-naïve patients admitted with ACS, early statin therapy was independently associated with lower incidence of in-hospital hyperglycemia. (Arq Bras Cardiol. 2021; 116(2):285-294)