Statin Medication: Scoping Review with ☸SAIMSARA

The aim of this scoping review is to synthesize multi-disciplinary evidence regarding the clinical outcomes, safety profiles, and determinants of adherence associated with statin medication across diverse global populations and clinical settings. The review utilises 1637 original studies with 43987683 total participants (topic deduplicated ΣN). The evidence map suggests that statin medication remains strongly associated with lower mortality and recurrent vascular events across major cardiovascular settings, with reported hazard ratios for mortality ranging from 0.38 after ischemic stroke to 0.71 in primary prevention populations. At the same time, the mapped literature highlights a consistent safety and implementation tension: new-onset diabetes and glycemic progression were repeatedly associated with statin exposure, with odds ratios up to 1.48 in postmenopausal women and a 46% increased risk reported in middle-aged men, while roughly half of patients showed suboptimal persistence within the first year. Beyond lipid lowering, the evidence supports broader anti-inflammatory, perioperative, hepatology, and selected oncology signals, but these noncardiovascular benefits were more heterogeneous and were often derived from observational or mechanistic studies rather than definitive trials. Clinically, the findings support continued emphasis on maintaining statin therapy in appropriate high-risk patients while proactively addressing adherence barriers, intolerance concerns, cost, and glycemic monitoring. Future research should prioritize better-controlled prospective studies and pragmatic trials that clarify heterogeneity in diabetes risk, muscle symptoms, neurologic associations, and potential repurposing benefits in cancer and liver disease.