Effect of Statins Alone Versus Statins Plus Ezetimibe on Carotid Atherosclerosis in Type 2 DiabetesThe SANDS (Stop Atherosclerosis in Native Diabetics Study) Trial
Jerome L. Fleg, MD*,
Mihriye Mete, PhD ,
Barbara V. Howard, PhD,
Jason G. Umans, MD, PhD,
Mary J. Roman, MD ,
Robert E. Ratner, MD,
Angela Silverman, MSN, CANP,
James M. Galloway, MD ,
Jeffrey A. Henderson, MD, MPH||,
Matthew R. Weir, MD¶,
Charlton Wilson, MD#,
Mario Stylianou, PhD* and
Wm. James Howard, MD**,*
* National Heart, Lung, and Blood Institute, Bethesda, Maryland
MedStar Research Institute, Hyattsville, Maryland
Weill Cornell Medical College, New York, New York
University of Arizona Health Science Center, Tucson, Arizona
|| Black Hills Center for American Indian Health, Rapid City, South Dakota
¶ University of Maryland School of Medicine, Baltimore, Maryland
# Phoenix Indian Medical Center, Phoenix, Arizona
** Washington Hospital Center, Washington, DC
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Figure 1 The SANDS Trial Participant Flow Diagram
The flow chart shows how participants were chosen and assigned to groups in the SANDS trial. CVD = cardiovascular disease; IMT = intima-media thickness; LDL-C = low-density lipoprotein cholesterol; SBP = systolic blood pressure; TG = triglyceride.
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Figure 2 Categorical Change in CIMT in SANDS Subgroups
Numbers represent percentages of participants who experienced a decrease or no change (open bars) in common carotid artery intima-media thickness (CIMT) >0.01 mm versus an increase (solid bars). The majority of both aggressive subgroups experienced a decline or no change in IMT, whereas the majority of the standard group showed an increase (p < 0.0001). E+ = statin plus ezetimibe; E– = statin alone.
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