Complications of Diabetes

Preventing Heart Disease in Diabetes – Evidence from the CARDS study

What is the CARDS study?

The Collaborative AtoRvastatin Diabetes Study (CARDS) was a large research study funded by Diabetes UK, the Department of Health and Pfizer.

The study was conducted in 132 centres across the UK and Ireland. A total of 2,838 people took part. Unlike previous statin trials, all of the participants in this study had type 2 diabetes. However none of them had previously had any history of cardiovascular disease.

Background to CARDS

It is known that people with type 2 diabetes have a higher risk of developing heart attacks and strokes. It is also known that the risk of dying from these conditions is doubled in type 2 diabetes.

The aim of the CARDS study was to examine the benefit of statins in people with Type 2 diabetes who did not already have evidence of cardiovascular disease.

What were the characteristics of people enrolled in the study?

  • Low levels of LDL cholesterol
  • No previous history of heart attack or stroke

What treatments were compared in the study?

Daily treatment with Atorvastatin 10mg was compared with placebo.

What did CARDS show?

The study showed a major reduction of 37 % in cardiovascular events i.e. heart attack, stroke or the need for cardiovascular surgery.

The risk of stroke was reduced by nearly 50%.

Can you explain the risk of heart attacks and strokes in more detail?

Out of 1000 people with type 2 diabetes who have not had vascular problems, 95 may be expected to have a major vascular event over a four year period. Taking 10 mg of Atorvastatin reduces this number of people to 58. i.e. 37 people avoid having a heart attack or stroke.

To prevent a single heart attack or stroke for four years it is estimated that the number of people who would need to be treated is 27.

What does this mean for me?

If you are someone with type 2 diabetes you may be able to lower your risk of heart attack or stroke by taking a statin (cholesterol lowering drug). You would best advised to discuss this further with your GP or during your next visit to the diabetes clinic.

What does this mean for people with type 1 diabetes?

This study tells us nothing about reducing risk in type 1 diabetes.

Where can I get more information?


Dr Nishan Wijenaike
Consultant Diabetologist
West Suffolk Diabetes Service
Bury St Edmunds
September 2004