title: Disparities in lipid control and statin drug use among diabetics with noncoronary atherosclerotic vascular disease vs those with coronary artery disease.
abstract: BACKGROUND
  Diabetes mellitus (DM), coronary artery disease (CAD), and noncoronary atherosclerotic vascular diseases (NCVDs) have similar risks of cardiovascular events and similar recommendations for lipid control. There are limited data regarding lipid control in diabetic patients with NCVD in current clinical practice.
  
  
  OBJECTIVE
  To assess current day practice of lipid control in patients with DM with NCVD vs those with CAD.
  
  
  METHODS
  We retrospectively identified 3336 patients with DM and known atherosclerotic vascular disease between January 2009 and March 2012. We compared demographic variables, lipid levels, and statin use in diabetics with CAD alone vs diabetics without CAD but with one or more NCVD.
  
  
  RESULTS
  There were 234 patients in DM with NCVD group and 3102 patients in DM with CAD group. The DM with NCVD group had a higher mean total cholesterol (152 ± 40 vs 146 ± 42 mg/dL; P = .019) and mean low-density lipoprotein (LDL; 86 ± 35 vs 80 ± 34 mg/dL; P = .04) with only 70% of patients achieving LDL of <100 mg/dL (compared with 80% in the DM with CAD group; P < .001). Statin use was 100% in CAD vs 75% in NCVD group (P < .001). In addition to limited use of more potent statins in the NCVD group, there was also a significantly lower dose of statins used overall.
  
  
  CONCLUSIONS
  Our study demonstrates lower use and less aggressive application of statins among diabetics with NCVD compared with diabetics with CAD, resulting in higher mean LDL and total cholesterol in the NCVD group.
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Diseases, University of Kansas Medical Center and Hospital, Kansas City, KS, USA.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Thapa
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Diseases, University of Kansas Medical Center and Hospital, Kansas City, KS, USA.
authors.forename: Suresh
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Diseases, University of Kansas Medical Center and Hospital, Kansas City, KS, USA.
authors.forename: Vinodh
authors.initials: V
authors.lastname: Jeevanantham
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Diseases, University of Kansas Medical Center and Hospital, Kansas City, KS, USA.
authors.forename: Casper
authors.initials: C
authors.lastname: Hu
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Diseases, University of Kansas Medical Center and Hospital, Kansas City, KS, USA.
authors.forename: Taylor
authors.initials: T
authors.lastname: Myers
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Diseases, University of Kansas Medical Center and Hospital, Kansas City, KS, USA.
authors.forename: James L
authors.initials: JL
authors.lastname: Vacek
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Diseases, University of Kansas Medical Center and Hospital, Kansas City, KS, USA.
authors.forename: Buddhadeb
authors.initials: B
authors.lastname: Dawn
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Diseases, University of Kansas Medical Center and Hospital, Kansas City, KS, USA. Electronic address: kgupta@kumc.edu.
authors.forename: Kamal
authors.initials: K
authors.lastname: Gupta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D048909:Diabetes Complications / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids
keywords: Abdominal aortic aneurysm; Carotid stenosis; Diabetes mellitus; Lipids; Noncoronary atherosclerotic vascular disease; Peripheral arterial disease; Statin