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The achievement of target cholesterol level differs between coronary heart disease and diabetic patients

Avishay Elis1, Gabriel Chodick, Anthony D Heymann

  • 1Department of Medicine, Meir Medical Center, Kfar Saba, Israel. avishayel@clalit.org.il

European Journal of Internal Medicine
|May 17, 2011
PubMed

Insights

Achieving target LDL-C levels is crucial for patients with diabetes mellitus (DM) and coronary heart disease (CHD). While CHD patients had higher success rates, diabetic patients require more attention and intensified cholesterol-lowering treatments.

Area of Science:

  • Cardiology
  • Endocrinology
  • Public Health

Background:

  • Current guidelines recommend low-density lipoprotein cholesterol (LDL-C) levels below 100 mg/dL for patients with diabetes mellitus (DM) and coronary heart disease (CHD).
  • Attaining these targets is critical for managing cardiovascular risk in high-risk populations.

Purpose of the Study:

  • To compare the achievement rates of LDL-C targets between patients with DM and CHD.
  • To identify demographic and clinical factors associated with achieving LDL-C goals in these patient groups.

Main Methods:

  • A retrospective analysis of electronic health records from Maccabi Healthcare Services in Israel.
  • Inclusion criteria: patients with DM, CHD, or both, with at least one LDL-C measurement between January 2007 and July 2008.
  • Analysis of the percentage of patients achieving LDL-C <100 mg/dL and its correlation with patient characteristics.

Main Results:

  • The rate of achieving LDL-C target levels was 50% for DM patients, 57% for DM and CHD patients, and 67% for CHD patients (p<0.001).
  • Predictors for goal achievement included male gender, higher socioeconomic status, presence of CHD, high statin compliance, and percutaneous coronary intervention.
  • Negative predictors included DM, lack of renal function evaluation, hospitalizations, and elevated HbA1c levels.

Conclusions:

  • Increasing the rate of LDL-C target achievement is essential for all high-risk patients, particularly those with diabetes.
  • Educational initiatives for physicians and patients are needed to emphasize treatment adherence and intensification of lipid-lowering therapies.
Abstract

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