Statin intensity regimens in Thai type 2 diabetic patients who achieved LDL-C targets

Abstract

Background: Type 2 diabetes mellitus (T2D) increases the risk of developing atherosclerotic cardiovascular disease (ASCVD). Statins reduce ASCVD events and are recommended in patients with T2D. Low-, moderate, and high-intensity regimens are predicted to achieve LDL-C reduction by about <30%, 30% to <50%, and ≥50%, respectively. Objective: To investigate the proportions of different statin intensity regimens used in patients with T2D that achieved LDL-C targets. Material and Method: This retrospective cross-sectional study was conducted in 269 T2D adults with LDL-C <100 mg/dL that were stratified into three groups by statin intensity according to 2013 ACC/AHA guideline. Factors significantly associated with higher-intensity statin use were determined by multivariate analysis. Results: Subjects were mostly elderly with long-standing T2D and hypertension (HT). Prevalence of ASCVD was 12.3%. Only 8.9% received high-intensity statins, while 40.9% and 50.2% received low- and moderate-intensity statins, respectively. Overall, attainment of LDL-C <70 mg/dL was 52.8%. Average LDL-C reduction was 54.6% (49.6%, 54.4%, and 59.7% in the low-, moderate-, and high-intensity groups, respectively). Rates of ASCVD, HT, and smoking were higher in the highintensity group. Factors significantly correlated with higher-intensity statin therapy included diabetic nephropathy (DN), HT, high-density lipoprotein cholesterol (HDL-C), and non-HDL-C levels (OR: 2.633, 2.381, 1.027, and 1.037, respectively). Conclusion: Low- and moderate-intensity statin users accounted for about 90% of Thai T2D patients who achieved LDL-C <100 mg/dL. LDL-C reduction in these two groups was greater than anticipated. HT and DN were associated with the use of higher-intensity statins to achieve LDL-C targets. © 2017, Medical Association of Thailand. All rights reserved.