title: The achievement of target cholesterol level differs between coronary heart disease and diabetic patients.
abstract: BACKGROUND
  Guidelines recommend that LDL-C level should be <100mg/dl among diabetes mellitus (DM) and coronary heart disease (CHD) patients.
  
  
  OBJECTIVE
  To evaluate how patients with DM and CHD differ in attaining the target level and to examine the association between goal achievement, demographic and clinical parameters.
  
  
  METHODS
  The study was conducted in Maccabi Healthcare Services, the second largest health maintenance organization in Israel. All patients with DM (n=54,261), CHD (n=24,083) or DM and CHD (n=15,370) who were listed in the computerized database and had at least one LDL-C level measurement between January 1, 2007 and July 15, 2008 were eligible. The percentage of patients who attained LDL-C level <100mg/dl and its association with demographic and clinical parameters were analyzed.
  
  
  RESULTS
  The rate of reaching the LDL-C target level was higher among the CHD and CHD and DM patients than DM ones (67% vs. 57% vs. 50%, p<0.001, respectively). Male gender; 5th socioeconomic status quintile; underlying disease i.e. CHD, CHD and DM; high statins compliance; and revascularization by percutaneous coronary intervention predicted for reaching target level. DM; absence of renal function evaluation; hospitalizations; HbA1C>7% or missing its measurements had a negative predictive value.
  
  
  CONCLUSIONS
  The rate of reaching LDL-C target level should be increased in all high risk patients, mainly diabetic ones. Efforts should include educational programs to physicians and patients regarding the importance, the need to adhere and to intensify the cholesterol lowering treatment.
authors.affiliation: Department of Medicine, Meir Medical Center, Kfar Saba, Israel. avishayel@clalit.org.il
authors.forename: Avishay
authors.initials: A
authors.lastname: Elis
authors.forename: Gabriel
authors.initials: G
authors.lastname: Chodick
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Heymann
authors.forename: Ehud
authors.initials: E
authors.lastname: Kokia
authors.forename: Shira
authors.initials: S
authors.lastname: Flash
authors.forename: Michael
authors.initials: M
authors.lastname: Lishner
authors.forename: Varda
authors.initials: V
authors.lastname: Shalev
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D008078:Cholesterol, LDL / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood* / Q000453:epidemiology; D016208:Databases, Factual / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000097:blood* / Q000453:epidemiology; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood* / Q000453:epidemiology; D007557:Israel / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012307:Risk Factors
chemical_list: D008078:Cholesterol, LDL