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

Abstract

Objective:

This analysis of the Lipid Treatment Assessment Project 2 population compared lipid goal attainment by diabetes and metabolic syndrome status.

Research design and methods:

Dyslipidaemic patients aged ≥20 years on stable lipid lowering therapy had their lipid levels determined once during enrolment at investigation sites in nine countries between September 2006 and April 2007. Achievement of low-density lipoprotein (LDL) cholesterol success, triglycerides <150 mg/dl (1.7 mmol/l), and high-density lipoprotein (HDL) cholesterol success (>40 mg/dl [1.0 mmol/l] in men or >50 mg/dl [1.3 mmol/l] in women) was compared using logistic regression.

Results:

A total of 9955 patients were evaluated. Patients with diabetes, compared with those without diabetes, had lower achievement of LDL cholesterol goals (according to National Cholesterol Education Program Adult Treatment Panel [NCEP ATP] III guidelines; 67% vs. 75%), triglycerides <150 mg/dl (55% vs. 64%), and HDL cholesterol success (61% vs. 74%; p < 0.0001 for all comparisons). The significantly lower lipid goal attainment in patients with diabetes was consistent across participating world regions. Patients with metabolic syndrome, compared with those without metabolic syndrome, had lower achievement of NCEP ATP III LDL cholesterol goals (69% vs. 76%), triglycerides <150 mg/dl (36% vs. 83%), and HDL cholesterol success (49% vs. 89%; p < 0.0001 for all comparisons). As the number of metabolic syndrome components increased, lipid success rates progressively decreased (p < 0.0001 for LDL cholesterol success, triglycerides <150 mg/dl, and HDL cholesterol success).

Conclusions:

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

Key words:

• Diabetes mellitus
• Dyslipidaemia
• Epidemiology
• Metabolic syndrome

Transparency

Declaration of funding

Pfizer Inc. funded this study, provided statistical support, funded editorial support and reviewed drafts of the manuscript.

Declaration of financial/other relationships

J.W.J. has disclosed that he has received research grants from and was speaker on (CME accredited) meetings sponsored by Astellas, AstraZeneca, Biotronik, Boston Scientific, Bristol-Myers Squibb, Cordis, Daiichi Sankyo, Ely Lilly, Medtronic, Merck/Schering-Plough, Novartis, OrbusNeich, Pfizer, Roche and Servier. C.-W.C. has no conflicts of interest to disclose. J.F. has disclosed that he has received research grants from AstraZeneca, Boehringer Ingelheim, Merck/Schering-Plough, Pfizer and Servier. R.D.S. has disclosed that he has received sponsorship from GlaxoSmithKline, Merck/Schering-Plough and Pfizer; research grants from AstraZeneca, ISIS-Genzyme, Pfizer and Roche; consulting fees from AstraZeneca, BIOLAB, GlaxoSmithKline, Merck/Schering-Plough and Novo Nordisk; and honoraria for speaking engagements from AstraZeneca, GlaxoSmithKline, Merck/Schering-Plough, Novartis and Pfizer. J.V. has disclosed that he has received research grants and honoraria for speaking engagements from MSD; and consulting fees from MSD and Merck/Schering-Plough. D.D.W. has disclosed that he has received consulting fees from Aegerion, Anthera, Biosante, Cerenus, Cortria, CSL Ltd, Genentech, Pfizer, Roche, and Servier; and owns Anthera stock options. M.M. and L.T. have disclosed that they are employees of and own stocks in Pfizer Inc.

Acknowledgements

Editorial support was provided by Dr Richard Hogan at UBC Scientific Solutions Ltd and was funded by Pfizer.

These data were presented at the 81st Scientific Sessions of the American Heart Association, November 8–12, 2008, New Orleans, LA, USA.