Cardio Round-Up: “Statin Intolerance” – Over Estimated & Over Diagnosed; and More

NOACs May Be Better Choice for Patients With A-Fib and DM

For patients with atrial fibrillation (AF) and diabetes mellitus (DM), non-vitamin K antagonist oral anticoagulants (NOACs) are associated with lower risks for diabetes complications and mortality than warfarin, according to a study published online Feb. 15 in the Annals of Internal Medicine.

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“NOAC may be a better therapeutic choice than warfarin for decreasing these complications and mortality in patients with AF and DM requiring oral anticoagulant treatment,” the authors write. “Future prospective studies and randomized controlled trials are necessary to determine the causal relations.”

“Statin Intolerance” – Over Estimated & Over Diagnosed

Statin intolerance is “over-estimated and over-diagnosed” according to the largest-ever study conducted on this phenomenon¹.

On behalf of the Lipid and Blood Pressure Meta-Analysis Collaboration and the International Lipid Expert Panel (ILEP), Professor Maciej Banach, of the Medical University of Lodz and the University of Zielona Góra in Poland, led a meta-analysis of 176 studies representing 4,143,517 patients worldwide. They set out to characterize both the prevalence of statin intolerance according to different diagnostic criteria and risk factors associated with greater risk of statin intolerance.

They found that the fears around statin intolerance are over-exaggerated. The overall prevalence of statin intolerance was 9.1% but varied depending on the diagnostic criteria used, as low as 5.9% using the European Atherosclerosis Society definition. Factors associated with greater prevalence of statin intolerance included age, female gender, Asian and Black race, obesity, diabetes mellitus, hypothyroidism, exercise, liver failure, and renal failure. Alcohol consumption and use of antiarrhythmic agents or calcium channel blockers were also associated with greater statin intolerance. As expected, greater statin dose increased the likelihood of statin intolerance, but not the lipid solubility of the prescribed statin.