Abstract
ObjectiveTo compare use of statins and target-goal achievement in patients with type 2 diabetes mellitus (T2DM), with or without stable coronary artery disease (CAD), between cardiology and endocrinology departments at a tertiary hospital.MethodsA total of 966 patients with T2DM were enrolled, including 553 with stable CAD, from the departments of endocrinology and cardiology. Baseline characteristics, prescription of statins, and target-goal achievement of low-density lipoprotein cholesterol (LDL-C) during a 6-month follow-up period were analyzed.ResultsThere was lower ratio of statin use in patients with T2DM, with or without CAD, in the department of endocrinology than in the department of cardiology (all P<0.05). At the 6-month follow-up, compared to patients with T2DM in the endocrinology department, target-goal achievement among patients with T2DM in the department of cardiology was higher (52.90% vs. 41.46%, P<0.01), indicating a significant improvement among patients in the department of cardiology but not for those in the department of endocrinology when compared to baseline. According to the new Chinese guidelines, the goal attainment rate was higher among patients with T2DM combined with CAD in the department of cardiology than in the department of endocrinology (27.62% vs. 19.05%, P<0.05). However, with regard to ATP III 2004, the goal attainment rate was similar for patients with T2DM combined with CAD in both departments during the 6-month follow-up (9.21% vs. 8.84%, P>0.05), with no apparent improvement compared to baseline.ConclusionsThere was differential and sub-optimal use of statins as well as low target-goal achievement among patients with T2DM, with or without CAD, in the departments of cardiology and endocrinology at the same tertiary hospital, with a lower rate of statin prescription and target-goal achievement of LDL-C in the department of endocrinology.
Highlights
Coronary artery disease (CAD) is one of the major causes of death in most countries, including China [1]
From January 2008 to December 2009, 966 patients diagnosed with type 2 diabetes mellitus (T2DM) were enrolled in this study, including 553 patients with documented stable CAD, from the departments of cardiology and endocrinology of the Affiliated Zhongda Hospital of Southeast University, a tertiary hospital located in Nanjing, Jiangsu Province, China
Patients with T2DM from the department of endocrinology were younger than those from cardiology or compared to patients with T2DM combined with CAD in endocrinology (P,0.01)
Summary
Coronary artery disease (CAD) is one of the major causes of death in most countries, including China [1]. Numerous evidence-based interventions exist, ranging from glycemic and cardiometabolic risk-factor control to early screening for diabetes complications [12], and great progress has been achieved, as evidenced in population-based studies [13,14,15] Among these interventions, the protective effects of cholesterol-lowering therapy with statins in primary and secondary prevention have been well verified and acknowledged by many guidelines, and low-density lipoprotein cholesterol (LDL-C) control is the first target goal [8,9,10,11,16,17,18,19,20,21]. Aggressive application of nationally recommended prevention activities for CVD would potentially add millions of quality adjusted life-years to the adult population in the U.S and improve the average lifespan by at least 1.3 years [26]
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