title: Achieving cholesterol goals with low-cost 3-hydroxy-3-methylglutaryl coenzyme-A (HMG Co-A) reductase inhibitors.
abstract: OBJECTIVE
  The objective of this study was to determine the efficacy of widely available low-cost generic statins in achieving NCEP/ATP III cholesterol goals in diabetic patients seen in an indigent clinic.
  
  
  METHODS
  Retrospective chart review of patients seen in the pharmacist managed diabetes clinic between January 1, 2005 and February 10, 2010. 154 patient charts were reviewed, with 12 included for analysis. Patients were age >40, diagnosed with diabetes mellitus, referred to the pharmacy clinic for diabetes management, and treated with a study statin for 6 weeks. Patients were excluded for baseline triglycerides >400 mg/dL, treatment with a non-study lipid lowering therapy ≤6 weeks prior to baseline, or pregnancy. The primary endpoint was the proportion of patients with an LDL <100 mg/dL at 6 weeks. Secondary endpoints included an LDL <70 mg/dL, other cholesterol goals, and a 30% reduction in LDL at 6 weeks.
  
  
  RESULTS
  At the first follow-up, 33% (n = 4) of patients achieved an LDL <100 mg/dL, and 66.7% (n = 8) a 30% LDL reduction. Race was a significant predictor, with Caucasians having greater LDL reductions than non-Caucasians at 6 weeks (Pearson Correlation -0.595, p = 0.041). Higher doses were significant predictors of greater change in LDL (Pearson Correlation -0.708, p = 0.01).
  
  
  CONCLUSIONS
  Due to the small sample size, statistical power was not met. Both race and dose were significant predictors of LDL reduction. When controlled for race, dose remained a significant predictor of LDL reduction. Further studies with low-cost statins in a larger patient population are needed.
authors.affiliation: Assistant Professor Ambulatory Care, Texas Tech University Health Sciences Center School of Pharmacy, Abilene, TX mary.klein@ttuhsc.edu.
authors.forename: Mary S
authors.initials: MS
authors.lastname: Klein
authors.affiliation: Assistant Professor Ambulatory Care, Texas Tech University Health Sciences Center School of Pharmacy, Dallas, TX.
authors.forename: Robin L
authors.initials: RL
authors.lastname: Koffarnus
authors.affiliation: Assistant Professor Ambulatory Care, Texas Tech University Health Sciences Center School of Pharmacy, Abilene, TX.
authors.forename: Molly G
authors.initials: MG
authors.lastname: Minze
authors.affiliation: Assistant Professor Ambulatory Care, Texas Tech University Health Sciences Center School of Pharmacy, Abilene, TX.
authors.forename: Pamella
authors.initials: P
authors.lastname: Ochoa
mesh_terms: D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000037:antagonists & inhibitors / Q000097:blood*; D003920:Diabetes Mellitus / Q000097:blood* / Q000178:diet therapy*; D005260:Female; D005500:Follow-Up Studies; D006040:Goals; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics* / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol