The effect of statin therapy on vessel wall properties in type 2 diabetes without manifest cardiovascular disease

Beishuizen, E.D. (2008)

Doctoral Thesis

Cardiovascular disease is the principal cause of mortality in patients with type 2 diabetes mellitus. The present thesis describes a study, designed at a time-point when no primary prevention trial had yet been performed to investigate the effects of statin therapy on patients with type 2 diabetes without cardiovascular disease. We have performed a randomized, double-blind placebo-controlled trial in 250 type 2 diabetic patients without manifest cardiovascular disease. The aim of the study was to study non-invasively the effect of two year statin therapy on the vessel wall. We found no effect of two year statin therapy on carotid IMT as a reflection of the progress of atherosclerosis. We found no effect on endothelial function as assessed by FMD. The effect of statin therapy on CRP, as a marker for low grade inflammation, was only significant in a high- risk subgroup with the metabolic syndrome and a high LDL-cholesterol. There was no effect of two-year statin therapy on the prevalence of silent myocardial ischemia. In spite of these findings, we observed a lower cardiovascular event rate in patients on statin therapy, which is in line with other clinical trials.

• Cardiovascular disease
• C reactive protein
• Flow mediated dilation
• Intima-media thickness
• Silent myocardial ischemia
• Statins
• Type 2 diabetes

• All authors: Beishuizen, E.D.
• Supervisor: Meinders, A.E.; Jukema, J.W.
• Co-supervisor: Huisman, M.V.; Tamsma, J.T.
• Qualification: Doctor (dr.)
• Awarding Institution: Leiden University Medical Center (LUMC), Leiden University
• Date: 2008-12-04
• ISBN (print): 9789085594581