Effectiveness of rosuvastatin in low-density lipoprotein cholesterol lowering and National Cholesterol Education Program Adult Treatment Panel guideline III LDL-C goal attainment compared to other statins among diabetes mellitus patients: a retrospective study using an electronic medical records dataset in the United States

被引:15
作者
Fox, Kathleen M.
Gandhi, Sanjay K.
Ohsfeldt, Robert L.
Blasetto, James W.
Bays, Harold E.
机构
[1] Univ Maryland, Sch Med, Dept Epidemiol & Prevent Med, Baltimore, MD 20742 USA
[2] AstraZeneca Pharmaceut LP, Wilmington, DE USA
[3] Texas A&M Hlth Sci Ctr, Dept Hlth Policy & Management, College Stn, TX USA
[4] Louisville Metab & Atheroscleros Res Ctr, Louisville, KY USA
关键词
ATP III goal attainment; clinical practice; diabetes mellitus; LDL-C reduction; rosuvastatin;
D O I
10.1185/030079907X219580
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To compare effectiveness of rosuvastatin (RSV) with other statins on lowering low-density lipoprotein cholesterol (LDL-C) and LDL-C goal attainment among patients with type 1 or type 2 diabetes mellitus. Methods: A retrospective study using US General Electric Medical Systems (GEMS) database of patients with diabetes mellitus (109 code = 250, prescription for anti-diabetic medication or fasting blood glucose level >= 126mg/dL in the 12 months preceding statin therapy) treated across clinical practices in the US, who were newly prescribed statin therapy during August 2003 March 2006, was conducted. Multivariate linear and logistic regression models were used for analyzing prescription data with baseline LDL-C, age, gender, smoking, very high CHD risk, systolic blood pressure, and statin duration as covariates. Results: Of 4754 diabetes mellitus patients, 5% were prescribed RSV, 59% atorvastatin (ATV), 21 % simvastatin (SMV), 5% pravastatin (PRV), 2% fluvastatin (FLV), and 7% lovastatin (LOVE. RSV patients had significantly higher (p < 0.05) baseline mean LDL-C levels (138 vs. 117-131 mg/dL), lower average starting dose (11.7 vs. 17.G-63.7 mg) and were younger (p < 0.005) than patients on other statins (mean age 61 vs. 63-69 years). Percent LDL-C reduction was significantly greater (p < 0.0001) with RSV (28.4%) compared to ATV (22.5%), SMV (20.1 %), PRV (13.7%), FLV (15.8%), and LOV (17.3%). A greater (p < 0.05) proportion of RSV diabetes patients attained LDL-C goal < 100 mg/dL (72.8%) vs. diabetes mellitus patients on other statins (36.8-67.4%). Conclusions: Rosuvastatin was more effective in lowering LDL-C and achieving LDL-C treatment goals in the diabetes mellitus population as compared to other statins in real-world clinical practice setting. Validating study results in a different diabetes population with dispensed statin prescriptions will help increase general izabi lity of study findings.
引用
收藏
页码:2125 / 2133
页数:9
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