The impact of diabetes mellitus and HBV infection on major adverse cardiovascular events related to statin use for Chinese population with cardiovascular disease

BACKGROUNDThe association between hepatitis B virus (HBV) infection, diabetes mellitus (DM) and cardiovascular disease (CVD) remains uncertain. This study was aimed to investigate the impact of HBV infection and DM on 13 major adverse cardiovascular events (MACEs) among CVD patients with or without statin use. METHODS AND RESULTSIn total, 45,013 individuals participated in the baseline survey between June 2020 and August 2023. The patients were categorized into two groups according to their surface antigen status. Finally, a sample size of 496 participants was included in the study: patients with coexisting CVD and HBV (n = 225) and patients with CVD alone (n = 271).The implementation of statins has demonstrated the potential to reduce the incidence of coronary heart disease (CHD) and angina pectoris (AP) in individuals with CVD who are also affected by HBV infection. The analysis of stratification, taking into account the presence of DM, has demonstrated a significant increased vulnerability to myocardial infarction (MI), acute myocardial infarction (AMI), and heart failure (HF) among individuals with HBV infection combined with CVD. DM and hemoglobin A1c (HBA1c) level of [≥] 6 are identified as risk factors for the development of CHD, MI, AP, and hypertension. Our study also suggests that statin therapy led to a dose-dependent decrease in liver fibrosis, as well as improvement of the atherogenicity index and systemic inflammatory response in patients with CVD. CONCLUSIONOur study indicates that CVD patients who also have HBV infection or DM may experience a reduction in MACEs when treated with statins. Furthermore, our research indicates that focusing on long-term glycemic control is essential in this patient population in order to enhance cardiovascular outcomes. The observed improvements in hepatic function, atherosclerotic burden, and systemic inflammation associated with statin therapy may contribute to the favorable cardiovascular outcomes among individuals with CVD. Clinical PerspectiveO_ST_ABSWhat Is New?C_ST_ABSO_LIThis study investigates the association between statin therapy and major adverse cardiovascular events (MACEs) in Chinese patients with cardiovascular disease who have concurrent hepatitis B virus infection or diabetes mellitus. C_LIO_LIThe findings suggest potential cardiovascular benefits of statin therapy in this specific patient population. C_LIO_LIThe study explores the relationship between statin use and changes in hepatic function, atherosclerotic markers, and inflammatory parameters. C_LI What Are the Clinical Implications?O_LIThe results provide evidence supporting statin use in cardiovascular disease patients with hepatitis B virus infection or diabetes mellitus. C_LIO_LIGlycemic control appears to be an important factor in optimizing cardiovascular outcomes in these patients. C_LIO_LIRegular monitoring of hepatic and inflammatory markers may be valuable in assessing treatment response. C_LI