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Minerva Cardiology and Angiology 2023 June;71(3):249-56

DOI: 10.23736/S2724-5683.22.06189-0


language: English

Alert-LDL-2: adherence to guidelines and goals attainment in the treatment of diabetic patients with dyslipidemia

Mariarosaria DE LUCA 1 , Giorgio BOSSO 2, Giovanni ALMA 2, Vincenzo CARBONE 2, Ferdinando FERRARA 2, Biagio FIMIANI 2, Franco GUARNACCIA 2, Alessandro IANDOLO 2, Sabato MUROLO 2, Maurizio OLIVARES 2, Emanuele ROMEO 2, Giosuè SANTORO 2, Antonio VALVANO 2, Giovanni ZITO 2, Ugo OLIVIERO 1, 2

1 Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy; 2 Associazioni Regionali Cardiologi Ambulatoriali (ARCA) Campania, Naples, Italy

BACKGROUND: Type 2 diabetes mellitus is associated with a cluster of lipid and apolipoprotein abnormalities which increase the risk for atherosclerotic cardiovascular disease. The aim of this study was to evaluate the adherence to guidelines-oriented dyslipidemia treatment in diabetic patients and to assess the efficacy of a territorial goal-oriented program.
METHODS: One thousand seventy-one diabetic patients at very high cardiovascular risk were enrolled in this prospective study. They performed a clinical-laboratory follow-up program, received lifestyle recommendations and optimization of their antihyperlipidemic therapies. At the beginning and the 3-month follow-up visit, LDL-c data were collected, and further therapies were prescribed to the patients that did not reach the target. After 12 month follow-up, LDL-c data were collected again.
RESULTS: Diabetic patients significantly improved mean LDL cholesterol levels during one-year follow-up (LDLc mean value 135 mg/dL at baseline, 60 mg/dL at the end of the study), obtaining a greater reduction compared to non-diabetic patients participating in the same program. Accordingly, the percentage of patients that reached the lipid target was significantly higher in diabetic patients after 3-months and 12- follow-ups (P<0.05). Diabetic patients assuming statins, both in monotherapy and in combination with ezetimibe, increased during the follow-up (74.1% at the enrolment vs. 88.2% one year later). GLP1ra-treated patients achieved the greatest reduction in cholesterol levels compared to baseline.
CONCLUSIONS: The results of the study recommend encouraging strategies and appropriate treatments to achieve a targeted lipid profile in diabetic patients at very high cardiovascular risk.

KEY WORDS: Dyslipidemias; Diabetes mellitus, type 2; Lipids; Cholesterol; Hydroxymethylglutaryl-CoA reductase inhibitors

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