Statin prescription patterns among patients with type 2 diabetes mellitus for primary and secondary prevention of cardiovascular disease

Abstract

Individuals with Type 2 diabetes (T2D) face a significantly elevated cardiovascular disease (CVD) risk. Among the various risk factors, dyslipidemia is strongly associated with CVD. Statins are the first-line treatment for patients at risk. Their ability to effectively reduce low-density lipoprotein (LDL) levels has made them a cornerstone in the prevention and management of CVD. To assess the pattern of statin prescription in T2D patients and follow its use as a primary and secondary prevention for CVD. The study design was cross-sectional followed by a quasi-experimental pre–post intervention. 210 T2D patients were recruited to evaluate the statin use regarding type, dose, adherence, and reason for use. After reporting the statin use pattern, all patients were subjected to one or more drug interventions: education about the importance of statin use, initiating statin in those who didn’t use it before, changing the statin type and/or dose, adding ezetimibe, and insisting on drug adherence. 3 months later, the statin use pattern was reevaluated to assess the percentage of patients who reached LDL and non high-density lipoprotein (non-HDL) targets according to 2023 European Society of Cardiology guidelines. 210 T2D patients were recruited in the study with a mean age of 54.63 ± 9.77 years. 67.6% were females, and 49% were at very high CV risk. Only 90 (42.9%) were statin users with 12.2% adherence rate. Atorvastatin was the most prescribed statin. 55.3% (57 out of 103) of patients with a very high CV risk and 48.6% (17 out of 35) of patients with high CV risk were not on statin therapy. High-intensity statins were used by only 28.2% and 31.4% of very high and high CV risk patients, respectively. A few patients achieved the LDL and non-HDL targets on the first visit, even among statin users (6.6% and 7.7%, respectively). Despite the increased percentage of target achievement on second visit, only 64.3% of all included patients achieved LDL target, and 57.6% achieved non-HDL target. The majority of T2D patients were either non-statin or moderate-intensity statin users, despite their high and very high CV risk. High-intensity statins plus ezetimibe cannot always achieve LDL and non-HDL targets. Potential need for additional lipid-lowering therapies should be addressed. Not applicable.