Low statin use in people with diabetes despite cardioprotective effects

Low statin use in people with diabetes despite cardioprotective effects, study shows

Nearly 2 out of 5 people with diabetes who could benefit from statin therapy to lower their risk of future heart attack, stroke and related death were not prescribed one, according to a research letter published in the Journal of the American College of Cardiology.

The analysis also showed wide variation in statin use across cardiology practices included in the study.

Previous studies have shown that taking a statin can significantly cut the risk of a future cardiovascular event in people with diabetes.

Researchers say this study is one of the first to look at real-world trends in the use of statin therapy in this patient population and is intended to help inform and potentially improve practice performance and, ultimately, patient outcomes.

“Patients with diabetes, including those without established cardiovascular disease, have a very high risk of having a heart attack or stroke,” said Salim Virani, M.D., Ph.D., the senior author.

“In this study, we found 38 percent of patients with diabetes were not on a statin, which can be lifesaving.”

In November 2013, the American College of Cardiology and the American Heart Association issued guidelines stating that unless contraindicated, statin therapy should be started and maintained in 40-75 year old patients with diabetes whose LDL cholesterol level is ≥70 mg/dL based on an assessment of risk to prevent the development of cardiovascular disease.

The American Diabetes Association similarly recommends that a statin be used to supplement lifestyle changes in people with diabetes who are 40 and older, regardless of baseline LDL cholesterol levels or whether they have cardiovascular disease.

Statins work in several ways, including lowering or removing cholesterol and the buildup of plaque in the arteries and reducing inflammation.

While patients did not have overt cardiovascular disease, because they were seen at a cardiology practice, they may have had an acute cardiology-related issue and may not be representative of the general diabetes population.

Virani said an important next step is to identify barriers to statin use and leverage and test electronic medical record alerts and decision support tools at the point of care to improve guideline-driven statin use for risk reduction when appropriate.

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News source: ACC. The content is edited for length and style purposes.
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