Low Density Lipoprotein Cholesterol Target Goal Attainment Rate and Physician Perceptions about Target Goal Achievement in Korean Patients with Diabetes

被引:18
作者
Hwang, Jenie Yoonoo [1 ]
Jung, Chang Hee [1 ]
Lee, Woo Je [1 ]
Park, Cheol Young [2 ]
Kim, Sung Rae [3 ]
Yoon, Kun-Ho [3 ]
Lee, Moon Kyu [4 ]
Park, Sung Woo [2 ]
Park, Joong-Yeol [1 ]
机构
[1] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med, 388-1 Poongnap 2 Dong, Seoul 138736, South Korea
[2] Sungkyunkwan Univ, Sch Med, Kangbuk Samsung Hosp, Dept Internal Med, Seoul, South Korea
[3] Catholic Univ Korea, Coll Med, Dept Internal Med, Seoul, South Korea
[4] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Internal Med, Seoul, South Korea
关键词
Diabetes mellitus; type; 2; Hypercholesterolemia; Surveys;
D O I
10.4093/dmj.2011.35.6.628
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: This study aims to investigate the discrepancy between clinicians' perceptions and actual achievement rates of low density lipoprotein cholesterol (LDL-C) in Korean patients with diabetes according to updated American Diabetes Association (ADA)/American College of Cardiology Foundation (ACC) recommendations. Methods: This is a multi-center, retrospective, non-interventional, observational study. Diabetic patients aged 18 years or older were eligible if they had been diagnosed with hypercholesterolemia or were receiving a lipid-lowering therapy between May 2010 and August 2010. The information was obtained by reviewing medical records and using a self-completed questionnaire to examine physician perceptions. Results: A total of 2,591 subjects who satisfied the inclusion criteria were enrolled. Highest-risk and high-risk patients accounted for 61.9% and 38.1% of the patients, respectively. Although most (96.3%) underwent a statin monotherapy or a statin-based combination therapy, just 47.4% of patients attained the LDL-C target. However, the physicians' perceptions on target achievement rate (70.6%) were different from the actual results (47.4%). Many patients (65.3%) remained on the starting doses of statins, despite evidence of poor achievement of lipid goals. Conclusion: Only less than half of patients with diabetes attained the LDL-C goal. The surveys showed that poor physician performance might be due to the lack of recognition on ADA/ACC consensus causing a low LDL-C target attainment rate. Therefore, changes in doctor perception are needed to attain target LDL-C level and reduce cardiovascular risk in Korean patients with diabetes.
引用
收藏
页码:628 / 636
页数:9
相关论文
共 27 条
[1]   The independent effect of type 2 diabetes mellitus on ischemic heart disease, stroke, and death - A population-based study of 13000 men and women with 20 years of follow-up [J].
Almdal, T ;
Scharling, H ;
Jensen, JS ;
Vestergaard, H .
ARCHIVES OF INTERNAL MEDICINE, 2004, 164 (13) :1422-1426
[2]  
Alzahrani T, 2003, CAN J CARDIOL, V19, P1499
[3]   Early benefit from structured care with atorvastatin in patients with coronary heart disease and diabetes mellitus - A subgroup analysis of the GREek Atorvastatin and Coronary Heart Disease Evaluation (GREACE) Study [J].
Athyros, VG ;
Papageorgiou, AA ;
Symeonidis, AN ;
Didangelos, TP ;
Pehlivanidis, AN ;
Bouloukos, VI ;
Mikhailidis, DP .
ANGIOLOGY, 2003, 54 (06) :679-690
[4]   Response to comment on: American Diabetes Association. Standards of medical care in diabetes-2011 (vol 34, pg e54, 2011) [J].
Wysham, C. H. ;
Kirkman, M. S. .
DIABETES CARE, 2011, 34 (08) :1887-1887
[5]  
Bloomgarden ZT, 2011, DIABETES CARE, V34, P1887, DOI [10.2337/dc11-0840, 10.2337/dc11-1306, 10.2337/dc11-0007, 10.2337/dc11-1557]
[6]   Lipoprotein management in patients with cardiometabolic risk [J].
Brunzell, John D. ;
Davidson, Michael ;
Furberg, Curt D. ;
Goldberg, Ronald B. ;
Howard, Barbara V. ;
Stein, James H. ;
Witztum, Joseph L. .
DIABETES CARE, 2008, 31 (04) :811-822
[7]   Is diabetes a coronary risk equivalent? Systematic review and meta-analysis [J].
Bulugahapitiya, U. ;
Siyambalapitiya, S. ;
Sithole, J. ;
Idris, I. .
DIABETIC MEDICINE, 2009, 26 (02) :142-148
[8]   Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) [J].
Cleeman, JI ;
Grundy, SM ;
Becker, D ;
Clark, LT ;
Cooper, RS ;
Denke, MA ;
Howard, WJ ;
Hunninghake, DB ;
Illingworth, DR ;
Luepker, RV ;
McBride, P ;
McKenney, JM ;
Pasternak, RC ;
Stone, NJ ;
Van Horn, L ;
Brewer, HB ;
Ernst, ND ;
Gordon, D ;
Levy, D ;
Rifkind, B ;
Rossouw, JE ;
Savage, P ;
Haffner, SM ;
Orloff, DG ;
Proschan, MA ;
Schwartz, JS ;
Sempos, CT ;
Shero, ST ;
Murray, EZ .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 285 (19) :2486-2497
[9]   Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo-controlled trial [J].
Colhoun, HM ;
Betteridge, DJ ;
Durrington, PN ;
Hitman, GA ;
Neil, HAW ;
Livingstone, SJ ;
Thomason, MJ ;
Mackness, MI ;
Charlton-Menys, V ;
Fuller, JH .
LANCET, 2004, 364 (9435) :685-696
[10]   Validation of the Framingham Coronary Heart Disease prediction scores - Results of a multiple ethnic groups investigation [J].
D'Agostino, RB ;
Grundy, S ;
Sullivan, LM ;
Wilson, P .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 286 (02) :180-187