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Baseline characteristics of HPS participants by prior diabetes

This study analyzes lipid levels and major vascular events in diabetes patients on simvastatin treatment, showing significant reductions in coronary events and strokes. The data compares outcomes based on prior diabetes, sex, age, and lipid levels.

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Baseline characteristics of HPS participants by prior diabetes

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  1. Baseline characteristics of HPS participants by prior diabetes

  2. HPS: Baseline lipids (mmol/L) and apolipoproteins (g/L) by prior diabetes

  3. HPS: Baseline lipids (mg/dL) and apolipoproteins (g/L) by prior diabetes

  4. HPS: FACTORIAL TREATMENT COMPARISONS

  5. HPS: Mean (SE) differences in lipids during follow-up by diabetes

  6. SIMVASTATIN: MAJOR CORONARY EVENTS and STROKE by prior DIABETES Vascular event SIMVASTATIN PLACEBO Rate ratio & 95% CI & disease group (10269) (10267) STATIN better PLACEBO better Major coronary events Diabetes 279 (9.4%) 377 (12.6%) No diabetes 619 (8.5%) 835 (11.5%) 27% SE 4 All patients 898 (8.7%) 1212 (11.8%) reduction (2P<0.00001) Strokes Diabetes 149 (5.0%) 193 (6.5%) No diabetes 295 (4.0%) 392 (5.4%) 25% SE 5 All patients 444 (4.3%) 585 (5.7%) reduction (2P<0.00001) 0.4 0.6 0.8 1.0 1.2 1.4

  7. SIMVASTATIN: REVASCULARISATIONS and MAJOR VASCULAR EVENTS by prior DIABETES Vascular event SIMVASTATIN PLACEBO Rate ratio & 95% CI & disease group (10269) (10267) STATIN better PLACEBO better Revascularisations Diabetes 260 (8.7%) 309 (10.4%) No diabetes 679 (9.3%) 896 (12.3%) 24% SE 4 All patients 939 (9.1%) 1205 (11.7%) reduction (2P<0.00001) Major vascular events Diabetes 601 (20.2%) 748 (25.1%) No diabetes 1432 (19.6%) 1837 (25.2%) 24% SE 3 ALL PATIENTS 2033 (19.8%) 2585 (25.2%) reduction (2P<0.00001) 0.4 0.6 0.8 1.0 1.2 1.4

  8. SIMVASTATIN: MAJOR VASCULAR EVENT by YEAR in DIABETIC PATIENTS Year SIMVASTATIN PLACEBO Rate ratio & 95% CI of follow-up (2978) (2985) STATIN better PLACEBO better 1 143 (4.8%) 141 (4.7%) 2 110 (3.9%) 150 (5.3%) 3 109 (4.0%) 172 (6.5%) 4 101 (3.9%) 138 (5.6%) 5+ 138 (5.7%) 147 (6.4%) 22% SE 5 ALL FOLLOW-UP 601 (20.2%) 748 (25.1%) reduction (2P<0.00001) 0.4 0.6 0.8 1.0 1.2 1.4

  9. SIMVASTATIN: MAJOR VASCULAR EVENTS by YEAR in DIABETIC PATIENTS 30 Logrank p<0.00001 25 PLACEBO 20 15 SIMVASTATIN 10 5 0 0 1 2 3 4 5 6 Years of follow-up Benefit/1000(SE) -1(6) 13(8) 34(9) 47(10) 51(15) 58(48) People suffering events (%)

  10. SIMVASTATIN: MAJOR VASCULAR EVENTS by PRIOR DISEASE & prior DIABETES Prior disease & SIMVASTATIN PLACEBO Rate ratio & 95% CI diabetes (10269) (10267) STATIN better PLACEBO better CHD Diabetes 325 (33.4%) 381 (37.8%) No diabetes 1134 (19.8%) 1460 (25.7%) Other CVD Diabetes 141 (25.6%) 171 (32.9%) No diabetes 287 (19.8%) 362 (24.4%) No CVD Diabetes 135 (9.3%) 196 (13.5%) 24% SE 3 ALL PATIENTS 2033 (19.8%) 2585 (25.2%) reduction (2P<0.00001) 0.4 0.6 0.8 1.0 1.2 1.4

  11. SIMVASTATIN: MAJOR VASCULAR EVENTS by SEX & prior DIABETES Sex & SIMVASTATIN PLACEBO Rate ratio & 95% CI diabetes (10269) (10267) STATIN better PLACEBO better Male Diabetes 471 (22.8%) 580 (27.8%) No diabetes 1195 (21.1%) 1555 (27.6%) Female Diabetes 130 (14.2%) 168 (18.6%) No diabetes 237 (14.6%) 282 (17.2%) 24% SE 3 ALL PATIENTS 2033 (19.8%) 2585 (25.2%) reduction (2P<0.00001) 0.4 0.6 0.8 1.0 1.2 1.4

  12. SIMVASTATIN: MAJOR VASCULAR EVENTS by AGE & prior DIABETES Age & SIMVASTATIN PLACEBO Rate ratio & 95% CI diabetes (10269) (10267) STATIN better PLACEBO better <65 y Diabetes 263 (15.7%) 341 (20.1%) No diabetes 568 (17.6%) 750 (23.1%)  65 y Diabetes 338 (25.9%) 407 (31.6%) No diabetes 864 (21.3%) 1087 (26.9%) 24% SE 3 ALL PATIENTS 2033 (19.8%) 2585 (25.2%) reduction (2P<0.00001) 0.4 0.6 0.8 1.0 1.2 1.4

  13. SIMVASTATIN: MAJOR VASCULAR EVENTS by LDL CHOLESTEROL & prior DIABETES LDL cholesterol & SIMVASTATIN PLACEBO Rate ratio & 95% CI diabetes (10269) (10267) STATIN better PLACEBO better <3.0 mmol/L Diabetes 191 (15.7%) 252 (20.9%) No diabetes 407 (18.8%) 504 (22.9%)  3.0 mmol/L Diabetes 410 (23.3%) 496 (27.9%) No diabetes 1025 (20.0%) 1333 (26.2%) 24% SE 3 ALL PATIENTS 2033 (19.8%) 2585 (25.2%) reduction (2P<0.00001) 0.4 0.6 0.8 1.0 1.2 1.4

  14. SIMVASTATIN: MAJOR VASCULAR EVENTS by TRIGLYCERIDES & prior DIABETES Triglycerides & SIMVASTATIN PLACEBO Rate ratio & 95% CI diabetes (10269) (10267) STATIN better PLACEBO better <2.0 mmol/L Diabetes 270 (16.8%) 364 (22.8%) No diabetes 831 (18.9%) 1068 (24.1%)  2.0 mmol/L Diabetes 331 (24.1%) 384 (27.6%) No diabetes 601 (20.8%) 769 (27.1%) 24% SE 3 ALL PATIENTS 2033 (19.8%) 2585 (25.2%) reduction (2P<0.00001) 0.4 0.6 0.8 1.0 1.2 1.4

  15. SIMVASTATIN: MAJOR VASCULAR EVENTS by HDL CHOLESTEROL & prior DIABETES HDL cholesterol & SIMVASTATIN PLACEBO Rate ratio & 95% CI diabetes (10269) (10267) STATIN better PLACEBO better <0.9 mmol/L Diabetes 288 (25.9%) 356 (31.1%) No diabetes 530 (21.1%) 708 (29.3%)  0.9 mmol/L Diabetes 313 (16.8%) 392 (21.3%) No diabetes 902 (18.9%) 1129 (23.2%) 24% SE 3 ALL PATIENTS 2033 (19.8%) 2585 (25.2%) reduction (2P<0.00001) 0.4 0.6 0.8 1.0 1.2 1.4

  16. SIMVASTATIN: MAJOR VASCULAR EVENTS by ApoB/ApoA1 ratio & prior DIABETES ApoB/ApoA1 ratio & SIMVASTATIN PLACEBO Rate ratio & 95% CI diabetes (10269) (10267) STATIN better PLACEBO better <1.0 mmol/L Diabetes 301 (16.9%) 382 (21.6%) No diabetes 717 (18.3%) 899 (22.9%)  1.0 mmol/L Diabetes 300 (25.2%) 366 (30.1%) No diabetes 715 (21.3%) 937 (27.9%) 24% SE 3 ALL PATIENTS 2033 (19.8%) 2585 (25.2%) reduction (2P<0.00001) 0.4 0.6 0.8 1.0 1.2 1.4

  17. SIMVASTATIN: MAJOR VASCULAR EVENTS by DURATION OF DIABETES Duration (years) SIMVASTATIN PLACEBO Rate ratio & 95% CI (10269) (10267) STATIN better PLACEBO better <6 203 (18.9%) 247 (23.0%)  6 <13 201 (20.8%) 241 (25.6%)  13 197 (21.0%) 259 (26.7%) No diabetes 1432 (19.6%) 1837 (25.2%) 24% SE 3 ALL PATIENTS 2033 (19.8%) 2585 (25.2%) reduction (2P<0.00001) 0.4 0.6 0.8 1.0 1.2 1.4

  18. SIMVASTATIN: MAJOR VASCULAR EVENTS by TYPE OF DIABETES Type of SIMVASTATIN PLACEBO Rate ratio & 95% CI diabetes (10269) (10267) STATIN better PLACEBO better Type 1 43 (13.7%) 53 (17.5%) Type 2 558 (20.9%) 695 (25.9%) No diabetes 1432 (19.6%) 1837 (25.2%) 24% SE 3 ALL PATIENTS 2033 (19.8%) 2585 (25.2%) reduction (2P<0.00001) 0.4 0.6 0.8 1.0 1.2 1.4

  19. SIMVASTATIN: MAJOR VASCULAR EVENTS by HbA1c HbA1c (%) SIMVASTATIN PLACEBO Rate ratio & 95% CI (10269) (10267) STATIN better PLACEBO better <7.0 294 (18.3%) 360 (22.6%)  7.0 301 (22.6%) 373 (27.5%) No diabetes 1432 (19.6%) 1837 (25.2%) 24% SE 3 ALL PATIENTS 2033 (19.8%) 2585 (25.2%) reduction (2P<0.00001) 0.4 0.6 0.8 1.0 1.2 1.4

  20. SIMVASTATIN: HbA1c (% ± SE) amonga sample with DIABETES at entry

  21. SIMVASTATIN: Development of DIABETES in patients not known to have diabetes at entry

  22. SIMVASTATIN: Change in blood CREATININE (µmol/l ± se) from baseline to 4 years

  23. HPS: Effects of SIMVASTATIN on first and all major vascular events in those with and without diabetes

  24. P S 30 P S 20 P S 10 9% 13% 20% 25% 31% 36% 0 Diabetesalone Occlusive arterial disease alone Both arterial disease and diabetes Absolute effects of simvastatin allocation on 5-year rates of first major vascular event Risk reductions (SE): 18.4% (5.7) Proportional 32.9% (9.1) 24.5% (3.1) 44 (12) Absolute/1000 62 (8) 66 (21) P-value 0.0003 <0.0001 0.002 40 S=simvastatin-allocated P=placebo-allocated Proportion with first major vascular event (%)

  25. HPS: Conclusions for people with diabetes • Lowering LDL cholesterol by 1 mmol/L (40 mg/dL) reduces the risk of major vascular events by about one-quarter during 5 years of treatment • Similar proportional reductions in risk among people with or without diabetes ― irrespective of age, sex, vascular disease or lipid levels • Continued statin treatment prevents not only first but also subsequent major vascular events

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