There is nonacceptance among patients with diabetes regarding the clinicians’ recommendations on statin therapy. The consequences in the long run are unknown for statin nonacceptance. Patients treated at Mass General Brigham from 2000 to 2018 who had diabetes but did not have atherosclerotic cardiovascular disease (ASCVD) were included in a retrospective cohort analysis. The researchers examined the connection between the occurrence of CV events (Myocardial ischemia or ischemic stroke) and the delay in statin therapy due to patients' non-acceptance of the medication. Data on baseline features and statin non-acceptance were gathered from previously validated Natural Language Processing technology and electronic medical data. 3,769 (52.1%) of the 7,239 research participants were female, and their mean age was 55.0 (SD 11.9) years. Their baseline mean HbA1c was 7.5% (SD 1.9) and mean LDL-C was 138 (SD 28) mg/dl. Due to early non-acceptance, a total of 1,280 (17.7%) patients experienced a mean delay in statin medication of 2.7 (SD 3.1) years, during which time they saw a mean of 4.6 (SD 9.1) provider visits. After that, the patients' statin treatment lasted a mean of 7.1 (SD 4.8) years. During the 8.2 (SD 4.6) year mean follow-up period, 455 patients (6.3%) experienced a CV incident. All-cause mortality was considered as a competing risk, with 6.4% (95% CI 5.6-7.2) of patients who accepted the statin prescription advice and 8.5% (95% CI 6.8-10.5) of patients who first rejected it experiencing a CV event at 10 years (p = 0.001). In a multivariable Cox analysis that adjusted for patient demographics, comorbidities, and provider clustering, there was a greater risk of a cardiovascular incident associated with the first refusal of statin medicine (HR 1.49, 95% CI 1.16-1.91, p = 0.002). According to the study, those with diabetes without ASCVD who refrain from taking statins because of nonacceptance have a higher chance of cardiovascular events. This research reveals a previously unidentified gap which increases the burden of CV diseases in patients who are already at high risk.

56-OR: American Diabetes Association (ADA) 84th Scientific Sessions, 2024, 21- 24 June 2024, Orlando, Florida.