Lipid-Lowering Prescription Patterns in Patients With Diabetes Mellitus or Cardiovascular Disease

Alanna Chamberlain, Sarah S. Cohen, Jill M. Killian, Keri L. Monda, Susan A. Weston, Ted Okerson

Research output: Contribution to journalArticle

Abstract

The purpose of this study is to describe lipid-lowering therapy (LLT) prescriptions and low-density lipoprotein cholesterol (LDL-C) monitoring in patients with diabetes mellitus (DM) with or without concomitant cardiovascular disease (CVD). Olmsted County, Minnesota residents with a first-ever diagnosis of DM or CVD (ischemic stroke/transient ischemic attack, myocardial infarction, unstable angina pectoris, or revascularization procedure) between 2005 and 2012 were classified as having DM only, CVD only, or CVD + DM. All LLT prescriptions and LDL-C measurements were obtained for 2 years after diagnosis. A total of 4,186, 2,368, and 724 patients had DM, CVD, and CVD + DM, respectively. Rates of LDL-C measurement were 1.31, 1.66, and 1.88 per person-year and 14%, 32%, and 42% of LDL-C measurements were <70 mg/dl in those with DM, CVD, and CVD + DM. Within 3 months after diagnosis, 47%, 71%, and 78% of patients with DM, CVD, and CVD + DM were prescribed LLT. Most prescriptions were for moderate-intensity statins. Under one-fifth of patients with CVD and CVD + DM were prescribed high-intensity statins. Predictors of high-intensity statin prescriptions included male sex, having CVD or CVD + DM, increasing LDL-C, and LDL-C measured more recently (2012 to 2014 vs before 2012). In conclusion, a large proportion of patients at high CVD risk are not adequately treated with LLT. Despite often being considered a risk equivalent, patients with DM have substantially lower rates of LLT prescriptions and lesser controlled LDL-C than those with CVD or CVD + DM.

Original languageEnglish (US)
JournalAmerican Journal of Cardiology
DOIs
StatePublished - Jan 1 2019

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Prescriptions
Diabetes Mellitus
Cardiovascular Diseases
Lipids
LDL Cholesterol
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Therapeutics
Transient Ischemic Attack
Unstable Angina
Physiologic Monitoring

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Lipid-Lowering Prescription Patterns in Patients With Diabetes Mellitus or Cardiovascular Disease. / Chamberlain, Alanna; Cohen, Sarah S.; Killian, Jill M.; Monda, Keri L.; Weston, Susan A.; Okerson, Ted.

In: American Journal of Cardiology, 01.01.2019.

Research output: Contribution to journalArticle

Chamberlain, Alanna ; Cohen, Sarah S. ; Killian, Jill M. ; Monda, Keri L. ; Weston, Susan A. ; Okerson, Ted. / Lipid-Lowering Prescription Patterns in Patients With Diabetes Mellitus or Cardiovascular Disease. In: American Journal of Cardiology. 2019.
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