TY - JOUR
T1 - Lipid-Lowering Prescription Patterns in Patients With Diabetes Mellitus or Cardiovascular Disease
AU - Chamberlain, Alanna M.
AU - Cohen, Sarah S.
AU - Killian, Jill M.
AU - Monda, Keri L.
AU - Weston, Susan A.
AU - Okerson, Ted
N1 - Funding Information:
During the course of this research, Keri L. Monda and Ted Okerson were employees and stockholders of Amgen, Inc. Sarah S. Cohen received research grants from Amgen, Inc. Alanna M. Chamberlain is a Co-Investigator of the Rochester Epidemiology Project (R01 AG034676). All other authors report no conflict of interest.
Funding Information:
Funding Sources: This work was supported by grants from Amgen, Inc. (a biopharmaceutical company) Thousand Oaks, CA, USA and the National Institute on Aging (R01 AG034676), Bethesda, MD, USA. The funding sources did not have a role in any of the writing or preparation of this manuscript.
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85069636944&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85069636944&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2019.07.002
DO - 10.1016/j.amjcard.2019.07.002
M3 - Article
C2 - 31362878
AN - SCOPUS:85069636944
SN - 0002-9149
VL - 124
SP - 995
EP - 1001
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 7
ER -