Statins underused in patients with diabetes, noncoronary atherosclerosis

Statin use is lower and less aggressive among patients with diabetes and noncoronary atherosclerotic vascular disease compared with those with diabetes and CAD, according to recent findings.

Researchers conducted a retrospective, observational study of electronic medical records of 3,336 adult patients with diabetes at University of Kansas Hospital and Medical Center. Patients had diabetes and CAD (n = 3,102) or diabetes without CAD but with one or more of the following noncoronary atherosclerotic vascular diseases: peripheral arterial disease, abdominal aortic aneurysm or carotid stenosis (n = 234).

Patients with diabetes and noncoronary atherosclerotic vascular disease had higher mean total cholesterol than patients with diabetes and CAD (152 mg/dL vs. 146 mg/dL; P = .019). Patients with diabetes and noncoronary atherosclerotic vascular disease also had higher mean levels of LDL (86 mg/dL vs. 80 mg/dL; P = .04).

Although LDL was well controlled overall, the researchers observed a significant difference between the percentage of patients who achieved an LDL of less than 100 mg/dL (70% of patients with diabetes and noncoronary atherosclerotic vascular disease vs. 80% of patients with diabetes and CAD; P < .001). In addition, fewer patients with diabetes and noncoronary atherosclerotic vascular disease attained an LDL of less than 70 mg/dL (34% vs. 44%; P = .002).

All patients with diabetes and CAD were using statins compared with 75% of patients with diabetes and noncoronary atherosclerotic vascular disease (P < .001). Powerful statins were less commonly used in the diabetes and noncoronary atherosclerotic vascular disease group, and mean statin doses were lower overall in these patients.

“Our study suggests that physicians are more aggressive with lipid control in CAD patients than in [noncoronary atherosclerotic vascular disease] patients, despite concurrent diagnosis of diabetes mellitus at our medical center,” the researchers wrote. “The study results call for confirmation of these findings in other patient populations, and for organized programs to be implemented to improve health care providers’ awareness regarding the benefits of statins in this vulnerable group of patients who are at high risk of cardiovascular events.” – by Jennifer Byrne

Source: www.healio.com