Non-achievement of LDL-cholesterol targets in patients with diabetes at very-high cardiovascular risk receiving statin treatment: Incidence and risk factors

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:268

Article

Breuker, Cyril^1,2  Clement, Florian¹  Mura, Thibault³  Macioce, Valerie³  Castet-Nicolas, Audrey^1,5  Audurier, Yohan¹  Boegner, Catherine⁴  Morcrette, Emilie⁴  Jalabert, Anne¹  Villiet, Maxime¹  Avignon, Antoine^2,4  Sultan, Ariane^2,4 

[1] Univ Hosp, Clin Pharm Dept, 191 Ave Doyen Gaston Giraud, F-34295 Montpellier, France

[2] Univ Montpellier, CNRS, INSERM, PhyMedExp, Montpellier, France

[3] Univ Hosp, Clin Res & Epidemiol Unit, Montpellier, France

[4] Univ Hosp, Endocrinol Diabetol Nutr Dept, Montpellier, France

[5] Univ Montpellier, IRCM INSERM U1194, Montpellier, France

关键词: Type 2 diabetes;    Low-density lipoprotein cholesterol;    Cardiovascular risk;    Lipid-lowering therapy;   

DOI  :  10.1016/j.ijcard.2018.04.068

来源: Elsevier

【 摘 要 】

Background: Cardiovascular diseases are the first cause of mortality in patients with diabetes, and LDL-cholesterol is a well-established cardiovascular risk factor. This study aimed to assess rate of LDL-cholesterol target attainment among patients with diabetes at very-high cardiovascular risk treated with statins, and to identify predictive factors of non-attainment of target in this population. Methods: Patients were recruited in the Nutrition-Diabetes unit of Montpellier University Hospital, France, from 2014 to 2017. We included all consecutive patients with type 1 or type 2 diabetes receiving statin treatment and at very-high cardiovascular risk according to 2016 ESC guidelines, therefore having a LDL-cholesterol target of <1.8 mmol/L. LDL-cholesterol levels were measured upon admission. Variables independently associated with non-attainment of LDL-Cholesterol target were assessed using multivariable logistic regression. Results: 654 patients were included. Mean age was 63.8 years (SD 11.0), 41.9% were women and 42.3% had a history of cardiovascular disease. 59% of patients did not achieve LDL-cholesterol target, with a median value (inter-quartile range) of 2.4 mmol/L (2.1-2.9) versus 1.4 mmol/L (1.1-1.6) in patients at target. Risk of non-attainment of LDL-cholesterol target value was increased in women (odds ratio [95% confidence interval]: 2.27 [1.62-3.17]) and decreased in patients with history of coronary artery disease (0.64 [0.45-0.89]) or history of stroke or transient ischemic attack (0.59 [0.33-1.07]). Conclusions: Management of dyslipidemia is suboptimal, even in very-high risk patients with diabetes under statins. Lipid-lowering treatment should be intensified, in particular in very high risk patients with diabetes who are women or in primary cardiovascular prevention. (c) 2018 Elsevier B.V. All rights reserved.

【 授权许可】

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