OPTIMAL RANGE FOR LOW-DENSITY LIPOPROTEIN (LDL) FOR DIABETIC PATIENTS ON STATIN THERAPY FOR PRIMARY AND SECONDARY PREVENTION OF CARDIOVASCULAR EVENTS

• Published in: American journal of preventive cardiology 2024-09, Vol.19, p.100847
• Main Author: Mahmood, Riaz
• Format: Article
• Language: English
• ISSN: 2666-6677; 2666-6677
• DOI: 10.1016/j.ajpc.2024.100847

CVD Prevention – Primary and Secondary Cholesterol-lowering medications such as HMG-CoA reductase inhibitors or statins are a guideline recommendation for the prevention of cardiovascular events in patients with diabetes over the age of 40. High-intensity statins can reduce low-density lipoprotein LDL cholesterol levels by as much as 50%. The optimal LDL level for statin medication patients has not been well studied. Our study aimed to determine the optimal LDL range for cardiovascular outcomes for primary and secondary prevention among patients with diabetes taking a statin. A retrospective observational study of patients diagnosed with type 2 diabetes mellitus receiving statin therapy was evaluated and separated into groups based on their low-density lipoprotein (LDL) values, 100 mg/dL. The primary outcome of acute coronary syndrome and ischemic cerebrovascular accidents were analyzed in primary prevention and secondary prevention groups. A chi-squared analysis was used to determine which LDL range was deemed more effective and whether the LDL range was dependent on prevention outcomes. Additionally, a multinomial logistic regression was used to determine predictors for successful prevention management. Of the 11,529 patients, most of the patients were male (52.2%) and had an LDL range of >100 mg/dL (50.98%), followed by 71-100 mg/dL (26.90%), 51-70 mg/dL (12.23%), and < 50mg/dL (9.87%). Primary prevention and LDL range were statistically dependent (χ2=12.92, p=0.044), with the LDL range of 56-70 mg/dL displaying a lower-than-expected frequency for outcomes in primary prevention (z=-2.91). On multinomial logistic regression for cardiovascular outcomes LDL group was not a significant predicator (OR , 95% CI 0.86-1.60, p