Lipid Goals in Diabetic Patients. Clinical Implications after Application of a New Formula for LDL-cholesterol Calculation

Abstract

Background: There are clear recommendations for lipid management in diabetic patients. A new formula for the calculation of LDLcholesterol(LDL-C) would improve the inaccuracy of the Friedewald formula.Objectives: The aim of this study was to analyze the use of statins and the fulfillment of lipid goals in diabetic patients, evaluatingthe consequences of applying a new formula for LDL-C calculation.Methods: This was a descriptive, cross-sectional, multicenter study including type 2 diabetic patients over 18 years of age. LDL-Cwas calculated using the classic Friedewald formula and the new formula. Recommendations of the position document for the appropriateuse of statins from the Argentine Society of Cardiology were followed.Results: A total of 528 patients were included in the study. In secondary prevention, 77.2% of patients received statins (23.4% highintensitystatins) and 36.6% and 36.0% of these patients achieved the goals of LDL-C below 70% mg/dl and non-HDL-C below 100mg/dl, respectively. In 20.8% of patients with LDL-C below 70 mg/dl according to the Friedewald formula, this goal was not attainedwhen the new formula was applied. In primary prevention, 62.2% patients with risk factors or white organ damage received statins(14.7% high-intensity statins) and 20.9% and 20.4% achieved the goals of LDL-C below 70% mg/dl and non-HDL-C below 100 mg/dl. In 27.7% of patients with LDL-C below 70 mg/dl using the Friedewald formula, this goal was not reached when applying the newformula. More patients did not achieve the LDL-C goal with the new formula when the triglyceride level was higher.Conclusion: In this population, the appropriate use of statins and the fulfillment of lipid goals were poor. Applying the new LDL-Cformula optimized the evaluation of these patients.