Objective: To compare the efficacy of low intensity statin (simvastatin 10 mg) versus moderate and high intensity statins for primary prevention of non-fatal myocardial infarction and non-fatal stroke in type 2 DM patients.
Materials and Methods: A retrospective cohort study was conducted on type 2 DM patients without prior history of atherosclerotic cardiovascular disease [ASCVD] who attended the endocrine clinic, Faculty of Medicine Vajira Hospital between 1 January 2006 and 30 June 2016, and received statins for primary prevention of ASCVD. Data on cardiovascular events, including non-fatal MI and non-fatal stroke were collected. The association of intensity of statin with cardiovascular events was analyzed with Cox hazard model.
Results: Of the 1,100 type 2 DM patients without prior ASCVD, 446 patients (40.5%) received simvastatin 10 mg and 654 patients (59.5%) received other statins. Patients in the simvastatin 10 mg group had significant lower body mass index, cholesterol, triglyceride and LDL-c level at baseline, also had significant lower composite non-fatal MI and non-fatal stroke than other statins group (HR = 0.479, 95% CI 0.31 to 0.74, p = 0.001]. This was mainly contributed to lower non-fatal MI in the simvastatin 10 mg group (HR = 0.357, 95% CI 0.20 to 0.64, p = 0.001).
Conclusion: Low intensity statin may be sufficient for primary prevention of cardiovascular events in very low risk type 2 DM
patients.

Keywords: Low intensity statin, Non-fatal MI, Non-fatal stroke, Primary prevention