Publication date: Sep 16, 2025
There is no consensus for using statins for primary prevention of cardiovascular disease (CVD) and all-cause mortality in adults with type 1 diabetes mellitus (T1DM), because no randomized controlled trial has exclusively investigated statins in this population. In this study, the authors sought to evaluate the long-term risks and benefits of statins for primary prevention in adults with T1DM. We performed a sequential target trial emulation comparing statin initiation vs noninitiation using UK primary care data from the IQVIA Medical Research Data database. Persons aged 25 to 84 years with a diagnosis record of T1DM with prescription of insulin from January 2005 to December 2016 were included if they had baseline low-density lipoprotein-cholesterol (LDL-C) ≥2. 6 mmol/L (100 mg/dL) or non-high-density lipoprotein cholesterol ≥3. 4 mmol/L (130 mg/dL). Persons with preexisting coronary artery disease, myocardial infarction, stroke, heart failure, myopathy, liver disease, rheumatic heart disease, schizophrenia or cancer were excluded. Main outcome measures were all-cause mortality, major CVD and adverse events (myopathy and liver dysfunction). We estimated 10-year absolute risk differences (RDs) for the observational analogues of the intention-to-treat (ITT) and per-protocol (PP) effects. We included 4,176 statin initiator (mean age of 45 years, 33. 1%
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | Type 1 Diabetes |
| disease | MESH | cardiovascular disease |
| drug | DRUGBANK | Cholesterol |
| disease | MESH | coronary artery disease |
| disease | MESH | myocardial infarction |
| disease | MESH | stroke |
| disease | MESH | heart failure |
| disease | MESH | myopathy |
| disease | MESH | schizophrenia |
| disease | MESH | cancer |
| disease | MESH | liver dysfunction |
| disease | MESH | dyslipidemia |