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A study presented at the American Diabetes Association's 84th Scientific Sessions indicates that delaying statin therapy among patients with type 1 and type 2 diabetes substantially elevates the risk of cardiovascular events over a 10-year period.

Lead author Nisarg Shah, a medical student from Yale School of Medicine, presented findings emphasizing the adverse health outcomes associated with postponing statin treatment.

"We found that delays in statin therapy - even by just a few years - could have a significant risk for patients in terms of having poor health outcomes and adverse cardiovascular events," Shah explained, as per Medscape.

The retrospective observational study, conducted at Mass General Brigham in Boston and spanning from 2000 to 2018, included 7,239 patients with diabetes. Among them, 17.7% delayed starting statin therapy by an average of 2.7 years.

Comparatively, patients who promptly began statin treatment had a lower incidence of adverse cardiovascular events (6.4%) over the subsequent decade, whereas those who delayed treatment experienced significantly higher rates (8.5%, P = .001).

The study showed the critical role of statins in managing cardiovascular risk associated with diabetes, a condition known to predispose individuals to atherosclerotic cardiovascular disease (ASCVD).

Despite clinical guidelines recommending statin therapy for eligible patients aged 40-75 years, and beyond based on individual risk factors, a substantial portion of patients do not initially accept this treatment due to concerns about side effects or clinical inertia among physicians.

According to senior author Alexander Turchin, MD, director of informatics research at Brigham and Women's Hospital, the study's findings highlight a public health issue, with nearly one-fifth of diabetes patients declining statin therapy recommendations.

"Given that nearly 20% of patients with diabetes did not accept statin therapy recommendations by their clinicians, it becomes an important public health issue," Turchin said.

The study also revealed that patients who delayed statin therapy had persistently higher LDL-cholesterol levels compared to those who started treatment promptly, reinforcing the importance of early intervention.

Commenting on the study, session moderator Mohammed K. Ali, MD, of Emory University, noted the widespread efficacy of statins in reducing cardiovascular events and emphasized the need for informed patient counseling to address hesitancy and improve treatment adherence.

"I think counseling and patient-centered decision-making is like a dance led by the clinician," Ali said. "A deft clinician will offer data as the conversation with the patient evolves. In the circumstance of sensing hesitancy, these data points, especially if conveyed clearly -- such as [the current] study, showing that avoiding statins was associated with a 50% higher risk of heart attacks and stroke -- may be important in persuading the patient to take the statin."

The study's authors advocate for enhanced patient education and clinician-patient dialogue to ensure informed decision-making regarding statin therapy, aiming to mitigate cardiovascular risks in this high-risk population.