Lipid-lowering drugs are at risk for being underprescribed in DM

  • Chamberlain AM & al.
  • Am J Cardiol
  • 15 Jul 2019

  • International Clinical Digest
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Takeaway

  • Despite diabetes mellitus (DM) often being considered a risk equivalent, patients with DM are substantially less likely to be prescribed lipid-lowering therapy (LLT).
  • They are also more likely to have less well-controlled lipids than patients with cardiovascular disease (CVD) alone or with CVD+DM.

Why this matters

  • DM is associated with increased CVD risk.

Study design

  • Study population were residents of Olmsted County, Minnesota, with first-ever diagnosis of DM or CVD (ischemic stroke/transient ischemic attack, myocardial infarction, unstable angina pectoris, or revascularization procedure) during 2005-2012, including 4186, 2368, and 724 patients with DM, CVD, and CVD+DM, respectively.
  • Funding: Amgen; NIH.

Key results

  • Over 2 years, low-density lipoprotein cholesterol (LDL-C) measurement rates per person-year were 1.31, 1.66, and 1.88 for DM, CVD, and CVD+DM, respectively (P<.001>
  • Proportions of LDL-C levels ≥100 mg/dL were 48.3%, 28.6%, and 19.6% for DM, CVD, and CVD+DM, respectively (P<.001>
  • LLT prescription rates within 3 months of index were 47%, 71%, and 78%, respectively; they rose modestly thereafter in the DM group but remained 
  • High-intensity statins prescribed in

Limitations

  • Homogeneous, largely white population.
  • Adherence could not be determined.
  • Older data.