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Statin utilization and its predictors for the primary prevention of cardiovascular disease among type 2 diabetic
Feyisa Assefa Dhaba1, Wubshet Abraham Alemu1, Firaol Lamessa Kitila1
1Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, Assela University, Assella, Ethiopia.
Insights
Statin use for cardiovascular disease prevention in type 2 diabetes patients was suboptimal at 53.8%. Hypertension, dyslipidemia, and poor glycemic control significantly influenced statin prescription rates.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- Cardiovascular disease (CVD) is a leading cause of mortality in type 2 diabetes mellitus (T2DM) patients.
- Statins are crucial for primary CVD prevention in this high-risk population.
- Suboptimal statin utilization persists despite clinical guidelines.
Purpose of the Study:
- To evaluate statin utilization for primary CVD prevention among diabetic patients.
- To identify predictors of statin prescription in a resource-limited setting.
Main Methods:
- A hospital-based cross-sectional study involving 351 diabetic patients.
- Systematic random sampling was employed for participant selection.
- Data collected via interviewer-administered questionnaires and checklists; analyzed using logistic regression.
Main Results:
- Statin utilization for primary CVD prevention was 53.8%.
- Atorvastatin and simvastatin were the most prescribed statins.
- Hypertension, dyslipidemia, and uncontrolled glycemic control were associated with increased statin use.
Conclusions:
- Observed suboptimal statin use (53.8%) highlights a gap in primary CVD prevention for T2DM patients.
- Comorbidities significantly influence statin utilization.
- Quality improvement initiatives are crucial to align statin access with guidelines for patients with hypertension, dyslipidemia, and poor glycemic control.
Background:
Cardiovascular disease (CVD) is a major cause of mortality in patients with type 2 diabetes mellitus (T2DM). Statins are essential for the primary prevention of CVD in this high-risk group. Despite guideline recommendations, statin use remains suboptimal in clinical practice. Assessing statin utilization and identifying factors influencing their prescription are vital for enhancing evidence-based care, especially in resource-limited settings. Therefore, this study aimed to evaluate statin use and its predictors for primary CVD prevention among diabetic patients at Arsi Teaching and Referral Hospital in 2023.
Methods:
A hospital-based cross-sectional study was carried out among 351 diabetic patients at Arsi Teaching and Referral Hospital (ARTH) between February and September 2022. Participants were selected using a systematic random sampling method. Data were collected through a pretested, interviewer-administered structured questionnaire and a checklist. Trained nurses from the diabetic clinic conducted data collection. The collected data were initially entered into Epi Data version 7.2, then exported to SPSS version 26 (IBM, USA) for analysis. The association between statin use and potential predictors was examined using odds ratios (ORs) with 95% confidence intervals (CIs). Variables with a p-value below 0.05 in the multivariable logistic regression were considered statistically significant.
Results:
The prevalence of statin utilization for the primary prevention of CVD among type 2 diabetic patients on follow-up at Asella Teaching Hospital was 189 [(53.8%, 95% CI: 48.6%, 59.0%)]. The most commonly prescribed statin was atorvastatin, followed by simvastatin. The probability of statin use was greater in participants with hypertension [AOR=4.8, 95% CI (2.0-11.5)], dyslipidemia [AOR=10.5, 95% CI (2.0-11.5)], and uncontrolled glycemic control [AOR=8.0,95% CI (3.8-17.7)].
Conclusions:
Suboptimal statin utilization (53.8%) for primary CVD prevention in type 2 diabetes was observed, with utilization heavily influenced by comorbidities. Urgent quality improvement initiatives are needed to ensure statin access aligns with guideline recommendations for patients with hypertension, dyslipidemia, and poor glycemic control in the study area.
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