Traitement hypolipidémiant et atteinte des objectifs pour le LDL cholestérol chez le patient diabétique ayant présenté un syndrome coronaire aigu

Translated title of the contribution: Lipid-lowering treatment and low-density lipoprotein cholesterol target achievement in patients with type 2 diabetes and acute coronary syndrome

Jean Ferrières, Dominik Lautsch, Peter Bramlage, Martin Horack, Carl A. Baxter, Baishali Ambegaonkar, Peter P. Toth, Kian Keong Poh, Gaetano Maria De Ferrari, Anselm K. Gitt

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Patients with type 2 diabetes mellitus characteristically display an atherogenic lipid profile with high triglyceride concentrations, low high-density lipoprotein cholesterol (HDL-C) concentrations and low-density lipoprotein cholesterol (LDL-C) concentrations not always elevated. It is unclear if patients with diabetes who present with an acute coronary syndrome (ACS) receive different or more-potent lipid-lowering therapy (LLT). Aims: To investigate lipid abnormalities in patients with and without type 2 diabetes hospitalised for an ACS, and use of LLT before admission and 4 months after the event. Methods: Patients were included in the observational DYSIS II study if they were hospitalised for an ACS and had a full lipid profile. Results: Of 3803 patients, diabetes was documented in 1344 (54.7%). Compared to patients without diabetes, those with diabetes had a lower mean LDL-C (101.2 vs. 112.0 mg/dL; 2.6 vs. 2.9 mmol/L; P < 0.0001), with a greater proportion attaining concentrations < 70 mg/dL (1.8 mmol/L) (23.9% vs. 16.0%; P < 0.0001) and < 55 mg/dL (1.4 mmol/L) (11.3% vs. 7.3%; P < 0.0001), a higher mean triglyceride concentration (139.0 vs. 121.0 mg/dL; 1.6 vs. 1.4 mmol/L; P < 0.0001) and a lower HDL-C concentration. LLT was more commonly given to patients with diabetes (77.5% vs. 58.8%; P < 0.0001); there were no differences in types of therapy prescribed. Four months after hospitalisation, most patients from both groups were being treated with LLT (predominantly statin monotherapy). Conclusions: Despite the different lipid profiles, the type of LLT prescribed did not vary depending on the presence or absence of type 2 diabetes. There was no difference in LLT in patients with and without diabetes at 4-month follow-up, except for fibrates, which were used in 2% of patients with and 1% of patients without diabetes. Statin monotherapy of intermediate potency was the predominant treatment in both groups.

Translated title of the contributionLipid-lowering treatment and low-density lipoprotein cholesterol target achievement in patients with type 2 diabetes and acute coronary syndrome
Original languageFrench
JournalArchives of Cardiovascular Diseases
DOIs
Publication statusAccepted/In press - 2020

Keywords

  • Acute coronary syndrome
  • Diabetes
  • Hyperlipidaemia
  • Low-density lipoprotein cholesterol
  • Statins

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Lipid-lowering treatment and low-density lipoprotein cholesterol target achievement in patients with type 2 diabetes and acute coronary syndrome'. Together they form a unique fingerprint.

Cite this