{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:48:15Z","timestamp":1787014095612,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T00:00:00Z","timestamp":1708473600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100022720","name":"Health Bureau","doi-asserted-by":"publisher","award":["05190107"],"award-info":[{"award-number":["05190107"]}],"id":[{"id":"10.13039\/100022720","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The present study aimed to evaluate the effect of statin therapy for primary prevention of cardiovascular diseases (CVDs) when initiating therapy at different baseline low\u2010density lipoprotein cholesterol (LDL\u2010C) levels in patients with type 2 diabetes mellitus (T2DM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Using territory\u2010wide public electronic medical records in Hong Kong, we emulated a sequence of trials on patients with T2DM with elevated LDL\u2010C levels in every calendar month from January 2008 to December 2014. Pooled logistic regression was applied to obtain the hazard ratios for the major CVDs (stroke, myocardial infarction, heart failure), all\u2010cause mortality and major adverse events (myopathies and liver dysfunction) of statin therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The estimated hazard ratios (95% confidence intervals) of CVD incidence for statin initiation were 0.78 (0.72, 0.84) in patients with baseline LDL\u2010C of 1.8\u20102.5\u2009mmol\/L (i.e., 70\u201099\u2009mg\/dL) and 0.90 (0.88, 0.92) in patients with baseline LDL\u2010C \u22652.6\u2009mmol\/L (i.e., \u2265100\u2009mg\/dL) in intention\u2010to\u2010treat analysis, which was 0.59 (0.51, 0.68) and 0.77 (0.74, 0.81) in per\u2010protocol analysis, respectively. No significant increased risks were observed for the major adverse events. The absolute 10\u2010year risk difference of overall CVD in per\u2010protocol analysis was \u22127.1% (\u221210.7%, \u22123.6%) and \u22123.9% (\u22125.1%, \u22122.7%) in patients with baseline LDL\u2010C 1.8\u20102.5 and \u22652.6\u2009mmol\/L, respectively. The effectiveness and safety were consistently observed in patients aged &gt;75\u2009years initiating statin at both LDL\u2010C thresholds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared with the threshold of 2.6\u2009mmol\/L, initiating statin in patients with a lower baseline LDL\u2010C level at 1.8\u20102.5\u2009mmol\/L can further reduce the risks of CVD and all\u2010cause mortality without significantly increasing the risk of major adverse events in patients with T2DM, including patients aged &gt;75\u2009years.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.15503","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T03:20:35Z","timestamp":1708485635000},"page":"1877-1887","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Evaluating different low\u2010density lipoprotein cholesterol thresholds to initiate statin for prevention of cardiovascular diseases in patients with type 2 diabetes mellitus: A target trial emulation study"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6275-1147","authenticated-orcid":false,"given":"Eric Yuk Fai","family":"Wan","sequence":"first","affiliation":[{"name":"Department of Family Medicine and Primary Care Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region  China"},{"name":"Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region  China"},{"name":"Laboratory of Data Discovery for Health (D24H) Hong Kong Science and Technology Park, Sha Tin, Hong Kong Special Administrative Region  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Tak","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region  China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celine Sze Ling","family":"Chui","sequence":"additional","affiliation":[{"name":"Laboratory of Data Discovery for Health (D24H) Hong Kong Science and Technology Park, Sha Tin, Hong Kong Special Administrative Region  China"},{"name":"School of Nursing, Li Ka Shing Faculty of Medicine The University of Hong Kong, Hong Kong Special Administrative Region  China"},{"name":"School of Public Health, Li Ka Shing Faculty of Medicine The University of Hong Kong, Hong Kong Special Administrative Region  China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther Wai Yin","family":"Chan","sequence":"additional","affiliation":[{"name":"Centre for Safe Medication Practice and Research, Department 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