ORIGINAL ARTICLE   

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

DOI: 10.23736/S2724-5683.22.06189-0

Copyright © 2022 EDIZIONI MINERVA MEDICA

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