Guideline-recommended statin therapy use low in diabetes
NEW ORLEANS — There are significant gaps in the recommended use of statin therapy in patients with diabetes despite elevated risk, according to findings presented at the American College of Cardiology Scientific Session.
However, the researchers reported, patients with diabetes were more likely to have appropriate use of statin therapy than patients without diabetes.
Angela Lowenstern, MD, and colleagues analyzed data from the PALM registry comparing statin use among 2,943 patients with diabetes and 4,685 patients without diabetes treated at 140 practices in 2015.
“The PALM registry is unique in that it explores lipid management in a multifaceted manner,” Lowenstern, a cardiology fellow at the Duke Clinical Research Institute, said during the presentation.
The researchers found that patients with diabetes were more likely to be treated with a statin in high-risk primary prevention and secondary prevention groups compared with patients without diabetes.
Of the primary prevention patients with diabetes, only 60% were treated with a moderate- or high-intensity statin, Lowenstern and colleagues wrote. Only 35% of eligible patients with prior atherosclerotic CVD received a high-intensity statin. The difference was statistically significant in five of seven groups categorized by risk.
When comparing primary and secondary prevention patients not currently on a statin, patients with diabetes and those without had similar rates of prior statin use (17.4% vs. 18%), the researchers wrote.
Patients with diabetes were more likely to report, “I often worry about having a heart attack or stroke,” compared with patients without diabetes (11.6% vs. 7.5%; P < .001), Lowenstern and colleagues wrote.
Patients with diabetes were likely to believe their CV risk was higher than similarly aged peers (39.1% vs. 29.3%; P < .001), but also more likely to report concern that “statins can cause diabetes” (9.5% vs. 5.2%; P < .001) compared with patients without diabetes, the researchers wrote.
Lowenstern said patients with diabetes were less likely to report that having symptoms was related to why their statin therapy was stopped, but most patients in both groups said they would be willing to try a statin again.
“I found it very interesting that sometimes so many patients in both groups were willing to try a statin again and perhaps we need to try harder to re-address that age set,” Lowenstern said during the presentation. – by Earl Holland Jr.
Lowenstern A, et al. Abstract 1033-11. Presented at: American College of Cardiology Scientific Session; March 16-18, 2019; New Orleans.
Disclosure: Lowenstern reports no relevant financial disclosures.