Building on previously published results,1,2 we are presenting results on the low-density lipoprotein (LDL-C) management in a subgroup of patients with atherosclerotic cardiovascular diseases (ASCVD) and pre-existing diabetes from Alberta, Canada at the American Diabetes Association (ADA) 79th Scientific Session 2019 on June 8th in San Francisco, California.
Diabetes markedly increases the risk and accelerates the course of ASCVD. While the use of lipid-lowering therapy (LLT), such as statins, has been shown to reduce the risk of ASCVD events, there is limited real-world evidence on the management of LDL-C in patients with clinical ASCVD and comorbid diabetes in Canada.
This retrospective study is the largest of its kind in Canada with over 281,000 patients. The study cohort was developed using a validated algorithm of ASCVD ICD-9-CM/ICD-10-CA diagnostic codes, and several health-system datasets were linked to examine clinical characteristics and LDL-C levels in those receiving LLT after the first LDL-C test.
Among 144,607 patients with ASCVD and a prescription for LLT, nearly 20% (n=27,540) were identified with comorbid diabetes (mean age: 67.1 years, 65.4% male). Patients with ASCVD and pre-existing diabetes had a higher incidence of stroke, coronary atherosclerosis/myocardial infarction, or peripheral arterial disease compared with those without diabetes. Although, patients with pre-existing diabetes were more likely to receive LLT than those without pre-existing diabetes; nearly 50% did not achieve the recommended LDL-C threshold at their follow-up test, despite receiving LLT.
Multifaceted interventions may be required to improve cholesterol management of patients with ASCVD and diabetes in Alberta. Based on our study findings, further research is needed to examine whether improved lipid management among patients with ASCVD and pre-existing diabetes translates to improved clinical outcomes.
Interested in learning more? Please see the poster presented by Dr. Ming-Hui Tai at the ADA 79th Scientific Session., Check it out here: Low-Density Lipoprotein Cholesterol Management 2019.
MEDLIOR has a team of health economists and modelling experts with expertise in the development of simulation models using RWD. To meet payer and regulatory evidence requirements, our team of researchers offers leadership in the design and execution of modelling studies, supported by our multidisciplinary team in evidence generation and RWD analytics. We have access to national and provincial population data to support demographic projection models together with state-of-the-art patient-level and Markov structure models. Furthermore, we are eligible to access and link Health Systems Data sources in Alberta that capture health and economic measures for the Albertan population (4.2 million) for the past 20 years. A more recent and exciting development is our eligibility to access the soon-to-be-released linked dataset from Statistics Canada including Canadian Income Data, Canadian Cancer Registry and Health System Data sources for national and provincial-level analyses.
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- Chen G, Farris MS, Cowling T, Colgan S, Xiang P, Pericleous L, Rogoza RM, Tai MH, Anderson TJ. Treatment and Low-density Lipoprotein Cholesterol management in patients diagnosed with clinical Atherosclerotic Cardiovascular Disease in Alberta. Can J Cardiol. 2019 (In Press)
- Chen G, Farris MS, Cowling T, Tai M, Pinto L, Colgan S, Rogoza R, Anderson T. Low-density Lipoprotein Cholesterol Management in Patients with Atherosclerotic Cardiovascular Diseases and Pre-existing Diabetes in Alberta, Canada. Epidemiology – Cardiovascular Disease: 1482-P. Accepted for presentation at the American Diabetes Association (ADA) 79th Scientific Sessions 2019, June 8, 2019; San Francisco, California.