Objective It is well known that reducing low-density lipoprotein cholesterol (LDL-C) levels lowers cardiovascular mortality and morbidity in type 2 diabetic patients. The National Cholesterol Education Program Adult Treatment Panel (NCEP ATP) III recommended using statins with life style modification for lowering LDL-C less than 100 mg/dL at least for diabetic patients. We evaluated the attainment of the NCEP-ATP III LDL-C goal of less than 100 mg/dL in type 2 diabetic patients using statins in real clinical practice.
Methods A retrospective study was intended for patients prescribed statin newly at Pusanpaik Hospital from January 2008 to December 2009. Of the 2729 new users of statin therapy, 17% started on simvastatin, 23% on rosuvastatin, 49% on atorvastatin, and 11% on fluvastatin-XL. The proportion of patients who achieved the LDL-C goal of less than 100 mg/dL was assessed.
Results Patients using each statin were similar in age and sex. But baseline LDL-C was significantly lower in simvastatin group [122±37 mg/dL, P<0.05 vs atorvastatin (142± 34 mg/dL), fluvastatin-XL (143±39 mg/dL), and rosuvastatin (147±55 mg/dL)]. The average dosage was as follows: atorvastatin (22.7±13.7 mg), fluvastatin-XL (80.0±0.0 mg), rosuvastain (10.4±1.9 mg) and simvastatin (22.1±6.2 mg). Overall proportion of LDL-cholesterol goal attainment was 75%. The achieving rate was highest in atorvastatin group (86%) and lowest in fluvastatin-XL group (61%). But other groups had similar attainment rates (simvastatin 77%, rosuvastatin 77%).
Conclusion We found that overall 75% of patients using statins reached LDL-C goals, which is slightly higher rate than published in the several clinical trials. We guess that this higher achieving rate results from lower baseline LDL-C in our study. And it might be the result from education emphasizing the importance of lowering LDL-C.