Lipid goals among patients with diabetes or metabolic syndrome: Lipid Treatment Assessment Project (L-TAP) 2

Abstract

This analysis indicates that despite their increased cardiovascular risk, patients with diabetes or metabolic syndrome remain undertreated.

Prevalence of Dyslipidemia and Lipid Goal Attainment in Statin‐Treated Subjects From 3 Data Sources: A Retrospective Analysis

“…In terms of trends, in the present study, a lower percentage of individuals with an index lipid panel in 2003–2005 attained LDL‐C <100 mg/dL (51.3% in EMR, 63.5% administrative claims data) than those with an index lipid panel in the later years (67.8% in EMR, 71.5% administrative claims data). This improvement in goal attainment over the years has been reported by LTAP‐1 and LTAP‐2 and by Cohen et al, who evaluated LDL‐C goal attainment in NHANES over time. Cohen et al examined trends across NHANES surveys and found that there was a progressive increase in percentage of the population achieving LDL‐C <100 mg/dL, from 17% in NHANES II (1976–1980), to 23% in NHANES III (1988–1994), to 31% in NHANES (1999–2006).…”

“…In terms of trends, in the present study, a lower percentage of individuals with an index lipid panel in 2003-2005 attained LDL-C <100 mg/dL (51.3% in EMR, 63.5% administrative claims data) than those with an index lipid panel in the later years (67.8% in EMR, 71.5% administrative claims data). This improvement in goal attainment over the years has been reported by LTAP-1 19 and LTAP-2 24 who evaluated LDL-C goal attainment in NHANES over time.…”

“…Several epidemiological studies, including Return on Expenditure Achieved for Lipid Therapy in Asia (REALITY‐ASIA), INTERHEART, Lipid Treatment Assessment Project (LTAP)‐1, LTAP‐2, and National Cholesterol Education Program Evaluation Project Utilizing Novel E‐technology (NEPTUNE) II, which evaluated high‐risk patients treated with statins or some other lipid‐modifying therapy, reported a wide variation (18% to 43%) in attainment of LDL‐C <100 mg/dL, depending on the definition of high‐risk patients (CHD versus diabetes) and race . However, some studies have reported a high proportion of patients (50% to 70%) attaining LDL‐C levels <100 mg/dL, similar to the present study. Also, among the very high‐risk patients, 15% to 30% are reported to achieve the optional goal of LDL‐C <70 mg/dL.…”

Modulating peroxisome proliferator–activated receptors for therapeutic benefit? Biology, clinical experience, and future prospects

“…74 One can envision that patients with established coronary artery disease might benefit from an agent that improves glycemic control, reduces insulin resistance, promotes insulin sensitization, alters inflammation, and modulates plasma lipids away from a dyslipidemic pattern. 21,65,66 The properties of aleglitazar suggest that it might favorably alter atherosclerotic progression similar to what has been observed in prior intravascular ultrasound studies with TZD agents. 75,76 Finally, it may be that this class of therapy will prove beneficial in patients with metabolic syndrome, the precursor for diabetes.…”

Thyroid Hormone Analogues for the Treatment of Metabolic Disorders: New Potential for Unmet Clinical Needs?

“…Only 38% of patients achieved LDL targets set by the National Cholesterol Education Program, including 68% of low risk patients, 37% of high risk patients, and 18% of patients with CHD (9). In 2010, Lipid Treatment Assessment Project 2 showed some improvement; however, persons with diabetes still only met their LDL goals 67% of the time, and nondiabetics met their goal 75% of the time (10). These findings are likely related to several factors, including impaired adherence, lack of efficacy, and physician inertia (11).…”