After four weeks of treatment, the median level of low-density lipoprotein (LDL) cholesterol decreased by 42% in the atorvastatin group and by 1.3% in the placebo group. "Atorvastatin had no statistically significant effect on the composite primary end point of cardiovascular death, nonfatal myocardial infarction, and stroke in patients with diabetes receiving hemodialysis," the authors write. "Of nominal significance, more cases of fatal stroke occurred in the atorvastatin group (27) than in the placebo group (13). This finding is unexplained and could be a chance finding, particularly in view of the data from CARDS [the Collaborative Atorvastatin Diabetes Study], which indicate that atorvastatin lowers the incidence of stroke."
"In persons with type 2 diabetes mellitus who are receiving maintenance hemodialysis and have LDL cholesterol values between 80 and 190 mg per deciliter, routine treatment with a statin to reduce the primary composite end point of death from cardiac causes, myocardial infarction, and stroke is not warranted," the authors conclude. "The initiation of lipid-lowering therapy in patients with type 2 diabetes mellitus who already have end-stage renal disease may come too late to translate into consistent improvement of the cardiovascular outcome."

Patients with type 2 DM who are receiving hemodialysis have a higher annual incidence of CHD mortality, at 8.2%, than other patients with cardiovascular risk factors. The use of atorvastatin for 4 years in patients with type 2 DM who are receiving hemodialysis and who have LDL cholesterol levels between 80 and 190 mg/dL does not improve survival or cardiovascular endpoints.